Provider Demographics
NPI:1063617405
Name:DARBY, JUANITA E (DC)
Entity type:Individual
Prefix:DR
First Name:JUANITA
Middle Name:E
Last Name:DARBY
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:PO BOX 81765
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60681-0765
Mailing Address - Country:US
Mailing Address - Phone:312-635-6242
Mailing Address - Fax:312-635-2123
Practice Address - Street 1:800 S WELLS ST APT 1324
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4541
Practice Address - Country:US
Practice Address - Phone:312-635-6242
Practice Address - Fax:312-635-2123
Is Sole Proprietor?:No
Enumeration Date:2007-06-17
Last Update Date:2017-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012708111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor