Provider Demographics
NPI:1376977769
Name:AHRENS, TRAVIS J (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:J
Last Name:AHRENS
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 1:233 E WACKER DR
Mailing Address - Street 2:1402
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5104
Mailing Address - Country:US
Mailing Address - Phone:920-410-8728
Mailing Address - Fax:
Practice Address - Street 1:233 E WACKER DR
Practice Address - Street 2:1402
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5104
Practice Address - Country:US
Practice Address - Phone:920-410-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38.012838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor