Provider Demographics
NPI:1366740128
Name:DEIGNAN, NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:DEIGNAN
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 1:777 LAKE ZURICH RD
Mailing Address - Street 2:105
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3106
Mailing Address - Country:US
Mailing Address - Phone:847-277-2990
Mailing Address - Fax:847-277-2991
Practice Address - Street 1:777 LAKE ZURICH RD
Practice Address - Street 2:105
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3106
Practice Address - Country:US
Practice Address - Phone:847-277-2990
Practice Address - Fax:847-277-2991
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4200111N00000X
IL038011878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor