Provider Demographics
NPI:1679629240
Name:VALDEZ, RICHARD HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HENRY
Last Name:VALDEZ
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 1:2177 LANGFORD LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-8925
Mailing Address - Country:US
Mailing Address - Phone:630-871-3252
Mailing Address - Fax:
Practice Address - Street 1:751 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5904
Practice Address - Country:US
Practice Address - Phone:630-469-1527
Practice Address - Fax:630-469-1841
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor