Provider Demographics
NPI:1528196292
Name:VONBERGEN, VICTORIA (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:VONBERGEN
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 1:28662 W NORTHWEST HWY
Mailing Address - Street 2:STE 4
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5928
Mailing Address - Country:US
Mailing Address - Phone:847-382-2770
Mailing Address - Fax:847-382-2796
Practice Address - Street 1:28662 W NORTHWEST HWY
Practice Address - Street 2:STE 4
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5928
Practice Address - Country:US
Practice Address - Phone:847-382-2770
Practice Address - Fax:847-382-2796
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38-005709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK49051OtherMEDICARE
IL4982060OtherBLUE CROSS BLUE SHIELD