Provider Demographics
NPI:1043202344
Name:MUSOLINO, JOSEPH PATRICK (DC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:MUSOLINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E NORTHWEST HIGHWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6944
Mailing Address - Country:US
Mailing Address - Phone:847-873-0032
Mailing Address - Fax:
Practice Address - Street 1:1800 E NORTHWEST HIGHWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-6944
Practice Address - Country:US
Practice Address - Phone:847-873-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU82321Medicare UPIN
ILK09212Medicare ID - Type Unspecified