Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | IL | |
N | 111NN0400X | Neurology | IL |
NPI | 1780654681 |
---|---|
Provider Name | Dr. Craig Hilgendorf |
First Address | Wheaton, IL 60187-3581 |
Second Address | Wheaton, IL 60187-3581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LO1431 | (02) | IL |