Provider Demographics
NPI:1063421394
Name:SUBBER, CATHY LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:LYNN
Last Name:SUBBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 W. OGDEN AVENUE
Mailing Address - Street 2:SUITE 143
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5008
Mailing Address - Country:US
Mailing Address - Phone:630-355-8988
Mailing Address - Fax:630-355-8953
Practice Address - Street 1:1767 W. OGDEN AVENUE
Practice Address - Street 2:SUITE 143
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5008
Practice Address - Country:US
Practice Address - Phone:630-355-8988
Practice Address - Fax:630-355-8953
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
K05070Medicare UPIN