Healthcare Provider Details

I. General information

NPI: 1114849221
Provider Name (Legal Business Name): AURA IV THERAPIES AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 6TH AVE STE L
LA GRANGE IL
60525-5636
US

IV. Provider business mailing address

47 6TH AVE STE L
LA GRANGE IL
60525-5636
US

V. Phone/Fax

Practice location:
  • Phone: 708-937-9070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DRAGAN GASTEVSKI
Title or Position: PHYSICIAN
Credential: MD
Phone: 312-725-9454