| Ebaugh Chiro Llc | |
|
1001 75th St Ste 105, Woodridge, IL 60517-2608 | |
| (630) 395-7226 | |
| Not Available |
| Full Name | Ebaugh Chiro Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1001 75th St Ste 105, Woodridge, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700634904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Shawn Jason Ebaugh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669415428 PECOS PAC ID: 9133131840 Enrollment ID: I20060627000286 |
| Mailing Address | Practice Location Address |
|---|---|
| Ebaugh Chiro Llc 1029 Crestview Dr, Lemont, IL 60439-4324 Ph: (630) 308-0050 | Ebaugh Chiro Llc 1001 75th St Ste 105, Woodridge, IL 60517-2608 Ph: (630) 395-7226 |
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