Provider Demographics
NPI:1871939165
Name:AARESTAD, ROBERT ALLAN JR (DC, BS, MMP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLAN
Last Name:AARESTAD
Suffix:JR
Gender:M
Credentials:DC, BS, MMP
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:ALLAN
Other - Last Name:AARESTAD
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1312 BASSETT DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-5309
Mailing Address - Country:US
Mailing Address - Phone:309-264-3760
Mailing Address - Fax:
Practice Address - Street 1:15041 S VAN DYKE RD STE 101
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5805
Practice Address - Country:US
Practice Address - Phone:815-267-8596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor