Individual
DAVID ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
919 E CHURCH ST, SANDWICH, IL 60548-2215
(815) 786-7022
Mailing address
919 E CHURCH ST, SANDWICH, IL 60548-2215
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982019
BCBS PPO PROVIDER
IL
Enumeration date
03/18/2007
Last updated
07/08/2007
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