Provider Demographics
NPI:1417007196
Name:NOERENBERG, DAN T (DC)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:T
Last Name:NOERENBERG
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 1:953 N LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3061
Mailing Address - Country:US
Mailing Address - Phone:847-695-0220
Mailing Address - Fax:847-695-9565
Practice Address - Street 1:953 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3061
Practice Address - Country:US
Practice Address - Phone:847-695-0220
Practice Address - Fax:847-695-9565
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic