Provider Demographics
NPI:1528330651
Name:HOOTON, DALE JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:JAMES
Last Name:HOOTON
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 1:10540 S WESTERN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2536
Mailing Address - Country:US
Mailing Address - Phone:773-298-0990
Mailing Address - Fax:773-445-1364
Practice Address - Street 1:10540 S WESTERN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2536
Practice Address - Country:US
Practice Address - Phone:773-298-0990
Practice Address - Fax:773-445-1364
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor