Healthcare Provider Details

I. General information

NPI: 1912989070
Provider Name (Legal Business Name): RICHARD L GELBAND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 05/10/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 WALNUT AVE STE 2
DOWNERS GROVE IL
60515-4073
US

IV. Provider business mailing address

5204 WALNUT AVE SUITE 2
DOWNERS GROVE IL
60515
US

V. Phone/Fax

Practice location:
  • Phone: 630-505-4040
  • Fax:
Mailing address:
  • Phone: 630-505-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038004563
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: