Provider Demographics
NPI:1649597352
Name:SPANGLER, MATTHEW R (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:SPANGLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD STE 301N
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1266
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-468-1836
Practice Address - Street 1:1701 E EMPIRE ST STE 320
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-7900
Practice Address - Country:US
Practice Address - Phone:309-533-7131
Practice Address - Fax:630-320-1478
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038011658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor