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Organization
NECK AND BACK CLINIC, LTD.
Active
Organization
NECK AND BACK CLINIC, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK DAVID WALLERY D.C. (PRESIDENT)
(773) 283-3131
Entity
Organization
Contact information
Practice address
4176 WEST MONTROSE AVE, CHICAGO, IL 60641-2161
(773) 283-3131
(773) 283-0793
Mailing address
4176 WEST MONTROSE AVE, CHICAGO, IL 60641-2161
(773) 283-3131
(773) 283-0793
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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