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Individual

DR. MICHAEL G BANUELOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2502 N HARLEM AVE, ELMWOOD PARK, IL 60707-2020
(708) 452-1220
(708) 452-6043
Mailing address
2502 N HARLEM AVE, ELMWOOD PARK, IL 60707-2020
(630) 290-7850

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005878
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038005878
IL
Enumeration date
10/17/2005
Last updated
01/20/2022
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