Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | IL | |
N | 111NN1001X | Nutrition | IL |
NPI | 1457438491 |
---|---|
Provider Name | Dr. Clinton Edward Sexton |
First Address | Yorkville, IL 60560-8920 |
Second Address | Yorkville, IL 60560-8920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 25/09/2007 |