Provider Demographics
NPI:1457461873
Name:CHANG, SAEJIN (DC)
Entity Type:Individual
Prefix:DR
First Name:SAEJIN
Middle Name:
Last Name:CHANG
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 1:1222 NATCHEZ TRACE CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7151
Mailing Address - Country:US
Mailing Address - Phone:630-926-9309
Mailing Address - Fax:630-689-1216
Practice Address - Street 1:1222 NATCHEZ TRACE CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7151
Practice Address - Country:US
Practice Address - Phone:630-926-9309
Practice Address - Fax:630-689-1216
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor