Provider Demographics
NPI:1053607481
Name:CRESS, JOHN D (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:CRESS
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 1:1176 MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1335
Mailing Address - Country:US
Mailing Address - Phone:847-469-3272
Mailing Address - Fax:847-557-3980
Practice Address - Street 1:1176 MCHENRY RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1335
Practice Address - Country:US
Practice Address - Phone:847-469-3272
Practice Address - Fax:847-557-3980
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID038011950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038011950OtherILLINOIS PROFESSIONAL LICENSE #