Provider Demographics
NPI:1386181469
Name:ALVARADO, MARCUS DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:DANIEL
Last Name:ALVARADO
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 1:1210 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1925
Mailing Address - Country:US
Mailing Address - Phone:618-654-4520
Mailing Address - Fax:618-615-4819
Practice Address - Street 1:1210 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1925
Practice Address - Country:US
Practice Address - Phone:618-654-4520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00741700111N00000X
IL038.013163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor