Provider Demographics
NPI:1093783284
Name:OWEN, CURTIS H (DC)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:H
Last Name:OWEN
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 1:7008 W HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-1902
Mailing Address - Country:US
Mailing Address - Phone:773-763-2387
Mailing Address - Fax:773-763-0562
Practice Address - Street 1:7008 W HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1902
Practice Address - Country:US
Practice Address - Phone:773-763-2387
Practice Address - Fax:773-763-0562
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV01823Medicare UPIN
ILK11114Medicare ID - Type Unspecified