Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038-009507 | IL |
N | 111NN0400X | Neurology | 038009507 | IL |
N | 111NR0400X | Rehabilitation Chiropractor | 038009507 | IL |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 038009507 | IL |
NPI | 1912915752 |
---|---|
Provider Name | Dr. Salvatore Battaglia III |
First Address | Chicago, IL 60607-4754 |
Second Address | Chicago, IL 60607-4754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 03/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01630306 | BCBSIL (01) | IL |
2712360 | AETNA (01) | IL |
U87415 | (02) | IL |