Provider Demographics
NPI:1275726549
Name:LARCHER, ALFRED F JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:F
Last Name:LARCHER
Suffix:JR
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 1:7039 W. ADDISON
Mailing Address - Street 2:
Mailing Address - City:CHGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7039 W. ADDISON ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651
Practice Address - Country:US
Practice Address - Phone:773-921-5800
Practice Address - Fax:773-921-6111
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0001682601OtherBLUE CROSS & BLUE SHIELD