Healthcare Provider Details

I. General information

NPI: 1396334231
Provider Name (Legal Business Name): ARTHUR MONACO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 W HUBBARD ST STE 302
CHICAGO IL
60654-4916
US

IV. Provider business mailing address

346 BLOOMFIELD CIR
BLOOMINGDALE IL
60108-2551
US

V. Phone/Fax

Practice location:
  • Phone: 773-598-4387
  • Fax:
Mailing address:
  • Phone: 630-310-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.013649
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: