Individual
DEREK JUSTIN MAITLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
906 LACEY AVE, LISLE, IL 60532-1318
(630) 963-1410
Mailing address
538 S ILLINOIS AVE, VILLA PARK, IL 60181-2960
(630) 235-6433
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.013131
IL
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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