Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038-003987 | IL |
NPI | 1689606279 |
---|---|
Provider Name | Dr. Donna Ficaro |
First Address | Orland Park, IL 60462-6668 |
Second Address | Orland Park, IL 60462-3775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 30/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T37653 | (02) | IL |