Provider Demographics
NPI:1164430104
Name:ATERNINO, ALESSANDRO (DC)
Entity Type:Individual
Prefix:
First Name:ALESSANDRO
Middle Name:
Last Name:ATERNINO
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 1:574 FOXFORD RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1925
Mailing Address - Country:US
Mailing Address - Phone:312-231-7644
Mailing Address - Fax:630-516-1188
Practice Address - Street 1:13 N ADDISON RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3805
Practice Address - Country:US
Practice Address - Phone:630-516-1122
Practice Address - Fax:630-516-1188
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038010518OtherSTATE LICENSE
ILV10412Medicare UPIN
IL038010518OtherSTATE LICENSE