Provider Demographics
NPI:1245405885
Name:RASPER CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:RASPER CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-665-5469
Mailing Address - Street 1:1934 GREENSBORO DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-8032
Mailing Address - Country:US
Mailing Address - Phone:630-665-5469
Mailing Address - Fax:
Practice Address - Street 1:1934 GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-8032
Practice Address - Country:US
Practice Address - Phone:630-665-5469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038005070Medicaid
IL038005070Medicaid
ILT13869Medicare UPIN