Provider Demographics
NPI:1699467308
Name:MASTERS, ISAAC N (DC)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:N
Last Name:MASTERS
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 1:1008 SPRING CT
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5489
Mailing Address - Country:US
Mailing Address - Phone:217-883-2178
Mailing Address - Fax:
Practice Address - Street 1:616 W 5TH AVE STE A
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2921
Practice Address - Country:US
Practice Address - Phone:217-883-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013990111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation