Provider Demographics
NPI:1093246357
Name:LOMBOS, DESIREE (DC)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:LOMBOS
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 1:742 W BODE CIR APT 115
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2941
Mailing Address - Country:US
Mailing Address - Phone:224-306-4796
Mailing Address - Fax:
Practice Address - Street 1:923 N PLUM GROVE RD STE D
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5152
Practice Address - Country:US
Practice Address - Phone:630-635-6407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor