Organization
MARY TM DICERBO, PC
Active
Other names
Wellness from the Inside Out Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY TM DICERBO DC (OWNER)
(847) 550-1115
Entity
Organization
Contact information
Practice address
765 ELA RD, SUITE 105, LAKE ZURICH, IL 60047-2385
(847) 550-1115
(847) 550-1117
Mailing address
765 ELA RD, SUITE 105, LAKE ZURICH, IL 60047-2385
(847) 550-1115
(847) 550-1117
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932472
BCBS
IL
Enumeration date
04/26/2007
Last updated
10/12/2007
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