Provider Demographics
NPI:1760440473
Name:OXENDINE, DUKE V (DC)
Entity Type:Individual
Prefix:DR
First Name:DUKE
Middle Name:V
Last Name:OXENDINE
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 1:3817 N VERMILION ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1159
Mailing Address - Country:US
Mailing Address - Phone:217-446-4373
Mailing Address - Fax:217-446-4797
Practice Address - Street 1:3817 N VERMILION ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1159
Practice Address - Country:US
Practice Address - Phone:217-446-4373
Practice Address - Fax:217-446-4797
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL470554Medicare UPIN
IL209720Medicare ID - Type Unspecified