Individual
DR. MICHAEL JOSEPH CONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
806 W DAKOTA ST, SPRING VALLEY, IL 61362-1602
(815) 664-4858
(815) 664-2135
Mailing address
806 W DAKOTA ST, SPRING VALLEY, IL 61362-1602
(815) 664-4858
(815) 664-2135
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00621412
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/18/2005
Last updated
07/08/2007
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