Provider Demographics
NPI:1356478556
Name:ARNOLD, LURA J (DC)
Entity Type:Individual
Prefix:DR
First Name:LURA
Middle Name:J
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 N ATKINSON RD STE 104A
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7805
Mailing Address - Country:US
Mailing Address - Phone:847-223-8343
Mailing Address - Fax:847-223-8377
Practice Address - Street 1:100 N ATKINSON RD STE 104A
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7805
Practice Address - Country:US
Practice Address - Phone:847-223-8343
Practice Address - Fax:847-223-8377
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0034941743Medicare UPIN