Provider Demographics
NPI:1932415148
Name:WORLEY, RICHARD DUWAYNE (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:DUWAYNE
Last Name:WORLEY
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 1:2442 WAUPACA CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9562
Mailing Address - Country:US
Mailing Address - Phone:630-881-4467
Mailing Address - Fax:
Practice Address - Street 1:2442 WAUPACA CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9562
Practice Address - Country:US
Practice Address - Phone:630-881-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor