Provider Demographics
NPI:1780654681
Name:HILGENDORF, CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:HILGENDORF
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 1:1425 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3581
Mailing Address - Country:US
Mailing Address - Phone:630-668-9626
Mailing Address - Fax:630-668-9711
Practice Address - Street 1:1425 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3581
Practice Address - Country:US
Practice Address - Phone:630-668-9626
Practice Address - Fax:630-668-9711
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILLO1431Medicare UPIN
ILLO1431Medicare ID - Type Unspecified