Provider Demographics
NPI:1336688597
Name:LEDERMAN, ASHLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:LEDERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 BUTTERFIELD RD
Mailing Address - Street 2:STE 110
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8849
Mailing Address - Country:US
Mailing Address - Phone:630-510-0080
Mailing Address - Fax:
Practice Address - Street 1:440 W BOUGHTON RD
Practice Address - Street 2:#102
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1892
Practice Address - Country:US
Practice Address - Phone:630-517-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor