Provider Demographics
NPI:1306116975
Name:BROERING, ALAN DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:BROERING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:110 S WYNSTONE PARK DR
Mailing Address - Street 2:STE 105
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6980
Mailing Address - Country:US
Mailing Address - Phone:419-305-1377
Mailing Address - Fax:
Practice Address - Street 1:110 S WYNSTONE PARK DR
Practice Address - Street 2:STE 105
Practice Address - City:N BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6979
Practice Address - Country:US
Practice Address - Phone:419-305-1377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor