Provider Demographics
NPI:1124463617
Name:DURENBERGER, CALEB ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:CALEB
Middle Name:ANTHONY
Last Name:DURENBERGER
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 1:910 CURTISS ST
Mailing Address - Street 2:9
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4754
Mailing Address - Country:US
Mailing Address - Phone:612-965-8892
Mailing Address - Fax:
Practice Address - Street 1:18 W FIRST ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4173
Practice Address - Country:US
Practice Address - Phone:612-965-8892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor