Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | IL | |
N | 111NR0200X | Radiology | IL | |
N | 213ER0200X | Radiology | IL |
NPI | 1720170954 |
---|---|
Provider Name | Eldon Leonard Huslig |
First Address | Lombard, IL 60148 |
Second Address | Lombard, IL 60148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |