Healthcare Provider Details

I. General information

NPI: 1720071830
Provider Name (Legal Business Name): STEVEN BELANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 09/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E SAINT CHARLES RD STE. D.
VILLA PARK IL
60181-2440
US

IV. Provider business mailing address

507 E SAINT CHARLES RD STE. D.
VILLA PARK IL
60181-2440
US

V. Phone/Fax

Practice location:
  • Phone: 630-782-6279
  • Fax: 630-782-6281
Mailing address:
  • Phone: 630-782-6279
  • Fax: 630-782-6281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number03808699
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: