Provider Demographics
NPI:1609123249
Name:BOCKMAN, THOMAS C (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:BOCKMAN
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 1:3N071 SPRINGVALE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1561
Mailing Address - Country:US
Mailing Address - Phone:630-293-1470
Mailing Address - Fax:
Practice Address - Street 1:3N071 SPRINGVALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-1561
Practice Address - Country:US
Practice Address - Phone:630-293-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor