Provider Demographics
NPI:1780727198
Name:LIFKA, DAVID G (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:LIFKA
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 1:1660 N FARNSWORTH AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1892
Mailing Address - Country:US
Mailing Address - Phone:630-898-0101
Mailing Address - Fax:
Practice Address - Street 1:1660 N FARNSWORTH AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1892
Practice Address - Country:US
Practice Address - Phone:630-898-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4504888OtherBC-BS PROVIDER ID
IL206925Medicare ID - Type Unspecified
IL4504888OtherBC-BS PROVIDER ID