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General NPI Number Information
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NPI Number | 1407159262
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Entity Type | Individual
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Provider Name | GARY A. PECHO L.AC., MSOM
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Gender | Male
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1323 BUTTERFIELD RD STE 102
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5620
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Country | US
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Telephone | 331-343-3140
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Fax | 331-343-3233
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Provider Business Mailing Address
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Address Line | 1323 BUTTERFIELD RD STE 102
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5620
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Country | US
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Telephone | 331-343-3140
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Fax | 331-343-3233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.000921
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License Number State | IL
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