Individual
EZEQUIEL MALDONADO-VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2325 DEAN ST STE 800O, ST CHARLES, IL 60175-4821
(331) 442-5140
(217) 954-0135
Mailing address
2325 DEAN ST STE 800O, ST CHARLES, IL 60175-4821
(217) 778-6644
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38013547
IL
Other
Enumeration date
05/05/2020
Last updated
03/03/2023
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