# DC SPINAL WELLNESS & SPORTS REHABILITATION LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326373028
- **Authorized official:** DR. DANIEL COFFEY DC (PRESIDENT)
- **Authorized official phone:** (630) 916-8533

## Contact information

- **Practice address:** 310 S MAIN ST, 310E, LOMBARD, IL 60148-2691
- **Practice address phone:** (630) 916-8533
- **Practice address fax:** (630) 916-8538
- **Mailing address:** 310 SOUTH MAIN STREET, 310E, LOMBARD, IL 60148-4392
- **Mailing address phone:** (630) 916-8533
- **Mailing address fax:** (630) 916-8538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | 038008821 | IL | Yes |

## Other

- **Enumeration date:** 10/14/2009
- **Last updated:** 10/15/2009