Provider Demographics
NPI:1932528403
Name:MOZDZIEN, ADAM SEBASTIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SEBASTIAN
Last Name:MOZDZIEN
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 1:4830 N CUMBERLAND AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-2966
Mailing Address - Country:US
Mailing Address - Phone:708-769-0910
Mailing Address - Fax:
Practice Address - Street 1:4830 N CUMBERLAND AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2966
Practice Address - Country:US
Practice Address - Phone:708-769-0910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012596111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician