Provider Demographics
NPI:1346207735
Name:ZANGE, LINDA L (DC LIC AC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:ZANGE
Suffix:
Gender:F
Credentials:DC LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E OAKTON ST
Mailing Address - Street 2:STE 5
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2171
Mailing Address - Country:US
Mailing Address - Phone:847-724-2340
Mailing Address - Fax:847-348-3859
Practice Address - Street 1:1401 E OAKTON ST
Practice Address - Street 2:STE 5
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2171
Practice Address - Country:US
Practice Address - Phone:847-724-2340
Practice Address - Fax:847-348-3859
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003379111N00000X, 111NX0800X
IL198000134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
131842OtherUHC ACN
0168225337OtherBLUE CROSS BLUE SHIELD
131842OtherUHC ACN
T36477Medicare UPIN