Provider Demographics
NPI:1881773448
Name:DAVID FOSS D.C. LTD.
Entity type:Organization
Organization Name:DAVID FOSS D.C. LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:FOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-365-9887
Mailing Address - Street 1:108 VALLEY DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:ELBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60119-8872
Mailing Address - Country:US
Mailing Address - Phone:630-365-9887
Mailing Address - Fax:630-365-9879
Practice Address - Street 1:108 VALLEY DR
Practice Address - Street 2:SUITE F
Practice Address - City:ELBURN
Practice Address - State:IL
Practice Address - Zip Code:60119-8872
Practice Address - Country:US
Practice Address - Phone:630-365-9887
Practice Address - Fax:630-365-9879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2227094OtherBC/BS PROVIDER NUMBER