Provider Demographics
NPI:1124067442
Name:SERLIN, ANDREW B (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:SERLIN
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 1:3113 DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2402
Mailing Address - Country:US
Mailing Address - Phone:224-723-5693
Mailing Address - Fax:224-723-5073
Practice Address - Street 1:3113 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2402
Practice Address - Country:US
Practice Address - Phone:224-723-5693
Practice Address - Fax:224-723-5073
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor