Provider Demographics
NPI:1457438491
Name:SEXTON, CLINTON EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:EDWARD
Last Name:SEXTON
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 1:200 GARDEN ST
Mailing Address - Street 2:BLDG A UNIT D
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-8920
Mailing Address - Country:US
Mailing Address - Phone:630-882-8909
Mailing Address - Fax:630-882-8906
Practice Address - Street 1:200 GARDEN ST
Practice Address - Street 2:BLDG A UNIT D
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-8920
Practice Address - Country:US
Practice Address - Phone:630-882-8909
Practice Address - Fax:630-882-8906
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition