Provider Demographics
NPI:1083097372
Name:DRZEWIECKI, CHRISTIE (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:DRZEWIECKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 S ADDISON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1978
Mailing Address - Country:US
Mailing Address - Phone:810-252-4031
Mailing Address - Fax:
Practice Address - Street 1:199 S ADDISON RD STE 106
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1978
Practice Address - Country:US
Practice Address - Phone:810-252-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012993111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition