# ADVANCED SPINE & JOINT REHABILITATION SERVICE CORP

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

## Provider details

- **NPI number:** 1881888485
- **Authorized official:** DR. CHAD DALE WASSON D.C. (PRESIDENT)
- **Authorized official phone:** (630) 848-1708

## Contact information

- **Practice address:** 1555 NAPERVILLE WHEATON RD, SUITE 206, NAPERVILLE, IL 60563-1557
- **Practice address phone:** (630) 848-1708
- **Practice address fax:** (630) 566-1585
- **Mailing address:** 1555 NAPERVILLE WHEATON RD, SUITE 109, NAPERVILLE, IL 60563-1557
- **Mailing address phone:** (630) 848-1708
- **Mailing address fax:** (630) 566-1585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 038008808 | IL | — |
| 133VN1006X | Metabolic Nutrition Registered Dietitian | 1640091972 | IL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 036043862 | IL | Yes |

## Other

- **Enumeration date:** 08/28/2007
- **Last updated:** 05/21/2009