Provider Demographics
NPI:1063529840
Name:POTOCKI, ERIC N (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:N
Last Name:POTOCKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25W330 GENEVA RD
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2328
Mailing Address - Country:US
Mailing Address - Phone:630-310-0680
Mailing Address - Fax:
Practice Address - Street 1:25W330 GENEVA RD
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2328
Practice Address - Country:US
Practice Address - Phone:630-310-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor