Provider Demographics
NPI:1457393621
Name:PERNS, DAVID VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VINCENT
Last Name:PERNS
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 1:415 E GOLF RD STE 108
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4049
Mailing Address - Country:US
Mailing Address - Phone:847-364-0006
Mailing Address - Fax:847-364-0130
Practice Address - Street 1:415 E GOLF RD STE 108
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4049
Practice Address - Country:US
Practice Address - Phone:847-364-0006
Practice Address - Fax:847-364-0130
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL432370Medicare ID - Type Unspecified