Provider Demographics
NPI:1659685436
Name:SWENSON, VICTORIA (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:SWENSON
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 1:720 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1725
Mailing Address - Country:US
Mailing Address - Phone:815-735-3160
Mailing Address - Fax:
Practice Address - Street 1:54 W COUNTRYSIDE PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1959
Practice Address - Country:US
Practice Address - Phone:630-592-1286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor