Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 038.011701 | IL |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038.011701 | IL |
NPI | 1346560752 |
---|---|
Provider Name | Dr. Agnieszka Cluchey |
First Address | Galena, IL 61036-2346 |
Second Address | Galena, IL 61036-2346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 15/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346560752 | ALLIANCE, BCBS-IL, CIGNA, HEALTH PARTNERS, MEDICAL ASSOCIATES, MIDLANDS, UHC (01) | IL |
1346560752 | NPI (01) | IL |