Provider Demographics
NPI:1154831527
Name:PATRICK, DEAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:THOMAS
Last Name:PATRICK
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 1:750 FLETCHER DR STE 304
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4756
Mailing Address - Country:US
Mailing Address - Phone:847-888-3131
Mailing Address - Fax:
Practice Address - Street 1:750 FLETCHER DR STE 304
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4756
Practice Address - Country:US
Practice Address - Phone:847-888-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor