Provider Demographics
NPI:1265085575
Name:ENWRIGHT, PAIGE ALEXANDRIA (DC)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:ALEXANDRIA
Last Name:ENWRIGHT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PAIGE
Other - Middle Name:ALEXANDRIA
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4355 94TH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-3737
Mailing Address - Country:US
Mailing Address - Phone:262-994-9854
Mailing Address - Fax:
Practice Address - Street 1:100 N WAUKEGAN RD STE 105
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1600
Practice Address - Country:US
Practice Address - Phone:847-280-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013395111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner