Provider Demographics
NPI:1497938989
Name:GEC, ANGELO (DC)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:
Last Name:GEC
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 1:4727 WILLOW SPRINGS RD
Mailing Address - Street 2:SUITE 1S
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6140
Mailing Address - Country:US
Mailing Address - Phone:630-240-9821
Mailing Address - Fax:
Practice Address - Street 1:4727 WILLOW SPRINGS RD
Practice Address - Street 2:SUITE 1S
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6140
Practice Address - Country:US
Practice Address - Phone:630-240-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL908330Medicare PIN