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General NPI Number Information
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NPI Number | 1871049692
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Entity Type | Individual
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Provider Name | NICOLE THERESA GIACOPELLI DC
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Gender | Female
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 6000 E STATE ST STE 201
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City | ROCKFORD
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State | IL
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Zip | 61108-2521
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Country | US
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Telephone | 815-828-6007
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Fax |
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Provider Business Mailing Address
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Address Line | 930 PYOTT RD STE 102
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-8721
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Country | US
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Telephone | 815-890-6815
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Fax | 815-893-6958
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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 | 038.012997
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License Number State | IL
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