Provider Demographics
NPI:1386812311
Name:SCOTT B. ECKELBARGER D.C. - P.C.
Entity type:Organization
Organization Name:SCOTT B. ECKELBARGER D.C. - P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:ECKELBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-303-4499
Mailing Address - Street 1:1370 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4029
Mailing Address - Country:US
Mailing Address - Phone:630-303-4499
Mailing Address - Fax:630-898-9031
Practice Address - Street 1:435 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8167
Practice Address - Country:US
Practice Address - Phone:630-898-8900
Practice Address - Fax:630-898-9031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty