Provider Demographics
NPI:1104173731
Name:COONEY, SEAN (DC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:COONEY
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 1:2130 NACHTMAN CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3311
Mailing Address - Country:US
Mailing Address - Phone:630-209-5259
Mailing Address - Fax:
Practice Address - Street 1:2130 NACHTMAN CT
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3311
Practice Address - Country:US
Practice Address - Phone:630-209-5259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor