Provider Demographics
NPI:1457423774
Name:BELTON, IAN R (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:R
Last Name:BELTON
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 1:2835 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6345
Mailing Address - Country:US
Mailing Address - Phone:760-271-6872
Mailing Address - Fax:760-529-9561
Practice Address - Street 1:5608 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4420
Practice Address - Country:US
Practice Address - Phone:773-358-8600
Practice Address - Fax:773-304-2551
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26679111N00000X
IL038-010386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor