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NPI Code Detail

MEDICARE: JONATHAN DELVICARIO DC

MEDICARE: JONATHAN DELVICARIO DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor038.013167IL

General Provider Information

NPI Number : 1528567559
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN DELVICARIO DC
Provider Business Mailing Address
First Line : 1400 W NORTHWEST HWY
Second Line :
City : PALATINE
State : IL
Zip : 60067-1837
Country : US
Telephone Number : 847-496-4567
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W NORTHWEST HWY
Second Line :
City : PALATINE
State : IL
Zip : 60067-1837
Country : US
Telephone Number : 847-496-4567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2018
Last Update Date : 03/10/2020

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