Individual
DR. GERARD JOSEPH CICERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5636 W FULLERTON AVE STE B, CHICAGO, IL 60639-2352
(773) 237-8660
(773) 237-3159
Mailing address
5636 W FULLERTON AVE STE B, CHICAGO, IL 60639-2352
(773) 237-8660
(773) 237-3159
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X003537-1
NY
111NX0800X
Orthopedic Chiropractor
Primary
038004975
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0593824
AENTA
IL
01
—
1618615
BCBS
IL
01
—
350052261
MEDICARE R.R.
IL
01
—
619433
U.H.C.
IL
Enumeration date
11/28/2006
Last updated
10/09/2024
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