Provider Demographics
NPI:1992714216
Name:ORENCZAK, CHRISTOPHER WALTER (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WALTER
Last Name:ORENCZAK
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 1:3607 GRASSMERE RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8242
Mailing Address - Country:US
Mailing Address - Phone:360-854-5551
Mailing Address - Fax:630-236-1339
Practice Address - Street 1:3607 GRASSMERE RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8242
Practice Address - Country:US
Practice Address - Phone:360-854-5551
Practice Address - Fax:630-236-1339
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02223392OtherBCBS OF IL GROUP #
208367Medicare ID - Type UnspecifiedGROUP #
K05064Medicare UPIN