Provider Demographics
NPI:1801970603
Name:MYERS, JOHN ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:306 GLEN ELLYN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2126
Mailing Address - Country:US
Mailing Address - Phone:630-671-2225
Mailing Address - Fax:630-671-2225
Practice Address - Street 1:306 GLEN ELLYN RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2126
Practice Address - Country:US
Practice Address - Phone:630-545-2225
Practice Address - Fax:630-545-2830
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00442285OtherRAILROAD MEDICARE
IL038007473Medicaid
IL408470Medicare PIN
ILU53846Medicare UPIN