Provider Demographics
NPI:1548466998
Name:CAMDEN CHIROPRACTIC CENTER, PC
Entity type:Organization
Organization Name:CAMDEN CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:CAMDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-925-5541
Mailing Address - Street 1:100 S SAMPSON
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-1046
Mailing Address - Country:US
Mailing Address - Phone:309-925-5541
Mailing Address - Fax:309-925-4204
Practice Address - Street 1:100 S SAMPSON
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-1046
Practice Address - Country:US
Practice Address - Phone:309-925-5541
Practice Address - Fax:309-925-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1710079116OtherNPI, DR. DARREN CAMDEN
IL1710079116OtherNPI, DR. DARREN CAMDEN
IL915361Medicare ID - Type Unspecified