Provider Demographics
NPI:1386875490
Name:HOLCOMB, LEA MAE (DC)
Entity type:Individual
Prefix:DR
First Name:LEA
Middle Name:MAE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD
Mailing Address - Street 2:STE 301N
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1234
Mailing Address - Country:US
Mailing Address - Phone:630-320-6400
Mailing Address - Fax:630-701-1007
Practice Address - Street 1:281 W TOWNLINE RD
Practice Address - Street 2:STE 200
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4334
Practice Address - Country:US
Practice Address - Phone:224-207-4060
Practice Address - Fax:224-207-4065
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor