Provider Demographics
NPI:1326081233
Name:MALAVOLTI, AARON ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:ALAN
Last Name:MALAVOLTI
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 1:21 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-6420
Mailing Address - Country:US
Mailing Address - Phone:773-575-5112
Mailing Address - Fax:
Practice Address - Street 1:21 W. ELM ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-6420
Practice Address - Country:US
Practice Address - Phone:773-575-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor