Provider Demographics
NPI:1891013488
Name:MUZUMDAR, AMEY JAGDISH (DC)
Entity Type:Individual
Prefix:DR
First Name:AMEY
Middle Name:JAGDISH
Last Name:MUZUMDAR
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 1:850 N CASS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1777
Mailing Address - Country:US
Mailing Address - Phone:630-353-5250
Mailing Address - Fax:630-353-5251
Practice Address - Street 1:850 N CASS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1777
Practice Address - Country:US
Practice Address - Phone:630-353-5250
Practice Address - Fax:630-353-5251
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor