Individual
DR. EDVARD LC GEREGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1013 4TH STREET, FULTON, IL 61252-1715
(815) 589-3291
(815) 589-3291
Mailing address
1013 4TH STREET, FULTON, IL 61252-1715
(815) 589-3291
(815) 589-3291
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038006218
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002906967
BCBS
IL
Enumeration date
01/31/2007
Last updated
07/22/2010
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