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Organization
PICCOLO CHIROPRACTIC CLINIC SC
Active
Organization
PICCOLO CHIROPRACTIC CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE D PICCOLO D.C. (PRESIDENT)
(630) 820-0000
Entity
Organization
Contact information
Practice address
356 N LAKE ST, AURORA, IL 60506-4186
(630) 820-0000
(630) 906-1798
Mailing address
356 N LAKE ST, AURORA, IL 60506-4186
(630) 820-0000
(630) 906-1798
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38003855
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210654
MEDICARE PTAN
IL
Enumeration date
06/18/2007
Last updated
01/30/2013
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