Provider Demographics
NPI:1609981042
Name:CRESS, DALE (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:
Last Name:CRESS
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 1:373 S SCHMALE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2774
Mailing Address - Country:US
Mailing Address - Phone:630-653-7401
Mailing Address - Fax:630-653-7402
Practice Address - Street 1:373 S SCHMALE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2774
Practice Address - Country:US
Practice Address - Phone:630-653-7401
Practice Address - Fax:630-653-7402
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL780920Medicare ID - Type Unspecified