Desiree Lynette Norberg, D.C.
Individual provider Active NPI Chiropractor · Caseyville, IL
NPI 1093065641 · NPPES record last updated Sep 11, 2012
Key facts
- NPI
- 1093065641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2012002897 (MO)
- Practice address
- 901 Wells Ave
Lot D
Caseyville, IL 62232-2088 - Phone
- (618) 616-5273
- NPI assigned
- Sep 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012002897 | MO | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2012002897 | MO | Yes |
Addresses
Primary practice location
901 Wells Ave
Lot D
Caseyville, IL 62232-2088
Mailing address
901 Wells Ave
Lot D
Caseyville, IL 62232-2088
Phone (618) 616-5273
Other providers in Caseyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.