Provider Demographics
NPI:1245992502
Name:YARBROUGH, ANTHONY SHAQUILLE JR (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:SHAQUILLE
Last Name:YARBROUGH
Suffix:JR
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 1:43 S RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1587
Mailing Address - Country:US
Mailing Address - Phone:630-340-4253
Mailing Address - Fax:
Practice Address - Street 1:43 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-1587
Practice Address - Country:US
Practice Address - Phone:630-340-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor