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Individual

MICHAEL EDWARD DECUBELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6800 MAIN ST STE 16, DOWNERS GROVE, IL 60516-3495
(630) 435-6461
(630) 960-9924
Mailing address
5157 MAIN ST, SUITE 200, DOWNERS GROVE, IL 60515-4616
(630) 435-6461
(630) 960-9924

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-011235
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IL2004001
MEDICARE PTAN
IL
Enumeration date
11/12/2008
Last updated
07/01/2025
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