Individual
JOHN D POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
9194 W GOLF RD, NILES, IL 60714-5806
(847) 795-1700
(847) 795-1750
Mailing address
9194 W GOLF RD, NILES, IL 60714-5806
(847) 795-1700
(847) 795-1750
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630049
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
07/19/2006
Last updated
07/09/2007
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