Provider Demographics
NPI:1710041017
Name:MERSINGER, CHRISTOPHER ROSS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROSS
Last Name:MERSINGER
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 1:555 PLAINFIELD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7602
Mailing Address - Country:US
Mailing Address - Phone:630-887-9400
Mailing Address - Fax:630-887-9495
Practice Address - Street 1:555 PLAINFIELD RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7602
Practice Address - Country:US
Practice Address - Phone:630-887-9400
Practice Address - Fax:630-887-9495
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232771OtherBCBS
ILK39235Medicare PIN
ILK25393Medicare PIN
ILU89347Medicare UPIN