Provider Demographics
NPI:1487533089
Name:CAMBRON, JERRILYN
Entity type:Individual
Prefix:
First Name:JERRILYN
Middle Name:
Last Name:CAMBRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JERRILYN
Other - Middle Name:
Other - Last Name:BACKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4539
Mailing Address - Country:US
Mailing Address - Phone:630-889-6853
Mailing Address - Fax:
Practice Address - Street 1:200 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4539
Practice Address - Country:US
Practice Address - Phone:630-889-6853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227-007524225700000X
IL038-006873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist