Provider Demographics
NPI:1295896629
Name:COWART, DON J (DC)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:J
Last Name:COWART
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 1:1212 S. NAPER BLVD
Mailing Address - Street 2:STE. 115
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7300
Mailing Address - Country:US
Mailing Address - Phone:630-357-9833
Mailing Address - Fax:630-357-5427
Practice Address - Street 1:1212 S. NAPER BLVD
Practice Address - Street 2:STE. 115
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7300
Practice Address - Country:US
Practice Address - Phone:630-357-9833
Practice Address - Fax:630-357-5427
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2290015OtherBCBS
363392702Medicare UPIN
764910Medicare UPIN