Provider Demographics
NPI:1619935517
Name:ENGLISH, MARY E (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:ENGLISH
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 1:1509 W BERWYN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-8168
Mailing Address - Country:US
Mailing Address - Phone:773-334-7440
Mailing Address - Fax:773-334-7558
Practice Address - Street 1:1509 W BERWYN AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-8168
Practice Address - Country:US
Practice Address - Phone:773-334-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007113111N00000X
MA1759111N00000X
ILCERT. # 2865111NS0005X
IL038.007113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622530OtherBCBS PROVIDER NO.