Provider Demographics
NPI:1235209362
Name:LANGLEY, ROBERT ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:LANGLEY
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 1:808 RICKERT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0905
Mailing Address - Country:US
Mailing Address - Phone:630-718-1700
Mailing Address - Fax:630-718-1697
Practice Address - Street 1:808 RICKERT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-0905
Practice Address - Country:US
Practice Address - Phone:630-718-1700
Practice Address - Fax:630-718-1697
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL112030585991OtherHUMANA
IL2223339OtherBLUE CROSS BLUE SHIELD