Provider Demographics
NPI:1194830968
Name:GATTUSO, JOSEPH R (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:GATTUSO
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 1:500 W PALATINE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5835
Mailing Address - Country:US
Mailing Address - Phone:847-459-5950
Mailing Address - Fax:847-459-5950
Practice Address - Street 1:500 W PALATINE RD STE 106
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5835
Practice Address - Country:US
Practice Address - Phone:847-459-5950
Practice Address - Fax:847-459-5950
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor