Provider Demographics
NPI:1093722167
Name:GINZBURG, ALEXANDER (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:GINZBURG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 ALLENDALE DR
Mailing Address - Street 2:SUITE 2-E
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-2603
Mailing Address - Country:US
Mailing Address - Phone:847-913-7844
Mailing Address - Fax:847-897-5990
Practice Address - Street 1:540 ALLENDALE DR
Practice Address - Street 2:SUITE 2-E
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-2603
Practice Address - Country:US
Practice Address - Phone:847-913-7844
Practice Address - Fax:847-897-5990
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038010137Medicaid