Provider Demographics
NPI:1861767717
Name:ALTON, ADAM RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:RICHARD
Last Name:ALTON
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 1:1439 TODD FARM DR
Mailing Address - Street 2:APT 2
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1788
Mailing Address - Country:US
Mailing Address - Phone:407-803-3708
Mailing Address - Fax:
Practice Address - Street 1:1439 TODD FARM DR
Practice Address - Street 2:APT 2
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1788
Practice Address - Country:US
Practice Address - Phone:407-803-3708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-11
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012207111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor