Iatgw

NPI #1114098068 in Lake Zurich, Illinois

Provider Information

NPI Number: 1114098068
Entity Type: Organization
Organization Name: Iatgw
Primary Specialty: Chiropractor
Enumeration Date: Nov 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 765 ELA RD
Address 2: SUITE 105
City: Lake Zurich
State: Illinois
ZIP Code: 60047-2385
Phone: (847) 550-1115

Authorized Official

Name: MARY T.M. DICERBO, D.C.
Title: OWNER
Phone: (847) 550-1115

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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