Provider Demographics
NPI:1407971708
Name:BIFERO, ANTONIO E (DC, MBA, MS)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:E
Last Name:BIFERO
Suffix:
Gender:M
Credentials:DC, MBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 S LOOMIS ST APT C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4681
Mailing Address - Country:US
Mailing Address - Phone:773-427-0820
Mailing Address - Fax:
Practice Address - Street 1:4920 N CENTRAL AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2338
Practice Address - Country:US
Practice Address - Phone:847-845-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010099111N00000X
IL38010099111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Yes111N00000XChiropractic ProvidersChiropractor