Provider Demographics
NPI:1659493955
Name:LANDIN, DANA BRUCE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:BRUCE
Last Name:LANDIN
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 1:2010 LARKIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5845
Mailing Address - Country:US
Mailing Address - Phone:224-856-5617
Mailing Address - Fax:
Practice Address - Street 1:2010 LARKIN AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5845
Practice Address - Country:US
Practice Address - Phone:224-856-5617
Practice Address - Fax:224-856-5619
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor