Provider Demographics
NPI:1750312401
Name:WEINFURTNER, COREY PATRICK (DC)
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:PATRICK
Last Name:WEINFURTNER
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 1:3737 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-4372
Mailing Address - Country:US
Mailing Address - Phone:815-344-2700
Mailing Address - Fax:815-344-2727
Practice Address - Street 1:3729 W ELM ST
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050
Practice Address - Country:US
Practice Address - Phone:815-344-2700
Practice Address - Fax:815-344-2727
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL97416Medicare ID - Type UnspecifiedPROVIDER ID
ILU94821Medicare UPIN