Organization
DR JOHN T PATENAUDE & DR DAVID P PICCHIETTI SC
Active
Other names
Maves Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID P PICCHIETTI DC (PRESIDENT)
(847) 872-3456
Entity
Organization
Contact information
Practice address
11316 W WADSWORTH ROAD, BEACH PARK, IL 60099-3367
(847) 872-3456
(847) 872-3557
Mailing address
11316 W WADSWORTH ROAD, BEACH PARK, IL 60099-3367
(847) 872-3456
(847) 872-3557
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04982014
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/27/2007
Last updated
08/22/2020
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