Provider Demographics
NPI:1417023060
Name:STRETCH, GEORGE GARY (DN DOCTOR OF NAPRAPA)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GARY
Last Name:STRETCH
Suffix:
Gender:M
Credentials:DN DOCTOR OF NAPRAPA
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:GARY
Other - Last Name:STRETCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC LICENSED ACUPUNC
Mailing Address - Street 1:9 N 850 CHANNEL CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-464-5699
Mailing Address - Fax:
Practice Address - Street 1:70 N ALFRED AVE
Practice Address - Street 2:WEST UNIT
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-695-4847
Practice Address - Fax:847-695-4902
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0002208VP0000X
IL171100000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001625544OtherBLUE CROSS BLUE SHIELD
NMNMOORK18OtherBLUE CROSS BLUE SHIELD