Provider Demographics
NPI:1881358562
Name:NORGAARD, SAMUEL ENDRE (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ENDRE
Last Name:NORGAARD
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 1:1740 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-3946
Mailing Address - Country:US
Mailing Address - Phone:630-699-9858
Mailing Address - Fax:
Practice Address - Street 1:1740 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3946
Practice Address - Country:US
Practice Address - Phone:630-699-9858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor