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General NPI Number Information
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NPI Number | 1497938989
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Entity Type | Individual
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Provider Name | ANGELO GEC D.C
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Gender | Male
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 4727 WILLOW SPRINGS RD SUITE 1S
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City | LA GRANGE
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State | IL
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Zip | 60525-6140
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Country | US
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Telephone | 630-240-9821
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Fax |
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Provider Business Mailing Address
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Address Line | 4727 WILLOW SPRINGS RD SUITE 1S
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City | LA GRANGE
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State | IL
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Zip | 60525-6140
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Country | US
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Telephone | 630-240-9821
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-008969
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License Number State | IL
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