Healthcare Provider Details

I. General information

NPI: 1457136152
Provider Name (Legal Business Name): VINCENT JOSEPH GUZALDO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 W 22ND ST STE 22
OAK BROOK IL
60523-4637
US

IV. Provider business mailing address

2603 W 22ND ST STE 22
OAK BROOK IL
60523-4637
US

V. Phone/Fax

Practice location:
  • Phone: 630-317-7478
  • Fax: 630-317-7504
Mailing address:
  • Phone: 630-317-7478
  • Fax: 630-317-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38014020
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: