Provider Demographics
NPI:1063958932
Name:EMMERT, CHRISTOPHER A (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:EMMERT
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 1:9670 FRANKLIN AVE
Mailing Address - Street 2:UNIT 210
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-2724
Mailing Address - Country:US
Mailing Address - Phone:734-612-4665
Mailing Address - Fax:
Practice Address - Street 1:24020 W RIVERWALK CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-7103
Practice Address - Country:US
Practice Address - Phone:815-345-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor