Healthcare Provider Details

I. General information

NPI: 1992905194
Provider Name (Legal Business Name): MARIA A. CASTELLESE D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 BIESTERFIELD RD SUITE 211
ELK GROVE VLG IL
60007-3392
US

IV. Provider business mailing address

901 BIESTERFIELD RD SUITE 211
ELK GROVE VLG IL
60007-3392
US

V. Phone/Fax

Practice location:
  • Phone: 847-690-9492
  • Fax: 847-357-9181
Mailing address:
  • Phone: 847-690-9492
  • Fax: 847-357-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MARIA ASSUNTA CASTELLESE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 847-690-9492