Physician Compare National (NPI:1710989389)

HEALTHCARE PROVIDER: CARL J DESTEFANO DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1710989389
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022270768
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120425000762
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DESTEFANO
	Individual professional last name
Provider First Name	CARL
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NATIONAL UNIVERSITY OF ARTS AND SCIENCES, MEDICAL DEPARTMENT
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	65 N RIVER LN BLDG C
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 207
	Group Practice or individual's line 2 address
City	GENEVA
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	601342268
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6302087760
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M