Provider Demographics
NPI:1104477165
Name:DEMARIA, JEREMY (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:DEMARIA
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 1:728 ARIZONA PASS
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-2804
Mailing Address - Country:US
Mailing Address - Phone:847-287-1392
Mailing Address - Fax:
Practice Address - Street 1:999 N PLAZA DR
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-6022
Practice Address - Country:US
Practice Address - Phone:847-706-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor