Provider Demographics
NPI:1568702439
Name:ACTION CHIROPRACTIC AND SPORTS INJURY CENTER OF NAPERVILLE, LLC
Entity Type:Organization
Organization Name:ACTION CHIROPRACTIC AND SPORTS INJURY CENTER OF NAPERVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALPHA
Authorized Official - Last Name:DURNAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-699-9858
Mailing Address - Street 1:1740 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-3946
Mailing Address - Country:US
Mailing Address - Phone:630-699-9858
Mailing Address - Fax:630-305-0189
Practice Address - Street 1:1740 QUINCY AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3946
Practice Address - Country:US
Practice Address - Phone:630-699-9858
Practice Address - Fax:630-305-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012238111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty