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Individual

DAVID W FLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2900 FOXFIELD RD, ST CHARLES, IL 60174-5799
(630) 208-3200
(630) 208-3201
Mailing address
2900 FOXFIELD RD, ST CHARLES, IL 60174-5799
(630) 208-3200
(630) 208-3201

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-006950
IL
111NX0800X
Orthopedic Chiropractor
Primary
038-006950
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038006950
IL
01
110174190
RAILROAD MEDICARE
IL
01
4519993
BLUE SHIELD
IL
01
920450
MEDICARE PTAN (GROUP)
IL
01
920540022
MEDICARE PTAN (INDIVIDUAL)
IL
01
DB1658
RAILROAD MEDICARE PTAN (GROUP)
IL
01
P01051865
RAILROAD MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
11/08/2006
Last updated
04/04/2013
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