Provider Demographics
NPI:1336192772
Name:ROMINSKI, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ROMINSKI
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 1:2410 ALFT LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124
Mailing Address - Country:US
Mailing Address - Phone:847-888-3383
Mailing Address - Fax:
Practice Address - Street 1:2410 ALFT LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124
Practice Address - Country:US
Practice Address - Phone:847-888-3383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU77163Medicare UPIN