Provider Demographics
NPI:1760486203
Name:NORRIS, DARRIN (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:
Last Name:NORRIS
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 1:920 TALON DR
Mailing Address - Street 2:STE 101
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-1848
Mailing Address - Country:US
Mailing Address - Phone:618-632-2000
Mailing Address - Fax:618-632-2133
Practice Address - Street 1:920 TALON DR
Practice Address - Street 2:STE 101
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-1848
Practice Address - Country:US
Practice Address - Phone:618-632-2000
Practice Address - Fax:618-632-2133
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
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
IL8221298OtherBLUE CROSS BLUE SHIELD
IL58958OtherGHP
IL382977OtherHEALTHLINK
IL58958OtherCMR
MO114856OtherBLUE CROSS BLUE SHIELD
U67301Medicare UPIN
IL58958OtherGHP