Provider Demographics
NPI:1720589617
Name:SPEERS, DAVID (CPO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPEERS
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E WOODFIELD RD STE 555
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5130
Mailing Address - Country:US
Mailing Address - Phone:847-619-1701
Mailing Address - Fax:847-619-1702
Practice Address - Street 1:1701 E WOODFIELD RD STE 555
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5130
Practice Address - Country:US
Practice Address - Phone:847-619-1701
Practice Address - Fax:847-619-1702
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL211000176224P00000X
IL213000071222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist