Provider Demographics
NPI:1457437246
Name:ZUELKE, DAVID S (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:ZUELKE
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 1:244 E ROOSEVELT RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4647
Mailing Address - Country:US
Mailing Address - Phone:630-261-0001
Mailing Address - Fax:630-261-0607
Practice Address - Street 1:244 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4647
Practice Address - Country:US
Practice Address - Phone:630-261-0001
Practice Address - Fax:630-261-0607
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038005090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
131904OtherACN
IL2290023OtherBCBS
743220Medicare ID - Type Unspecified
IL2290023OtherBCBS