Provider Demographics
NPI:1942535299
Name:DOROUGH, RYAN I (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:DOROUGH
Suffix:I
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 1:415 W GOLF RD
Mailing Address - Street 2:UNIT #3
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3929
Mailing Address - Country:US
Mailing Address - Phone:847-981-8803
Mailing Address - Fax:
Practice Address - Street 1:415 W GOLF RD
Practice Address - Street 2:UNIT #3
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3929
Practice Address - Country:US
Practice Address - Phone:847-981-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor