Provider Demographics
NPI:1518071901
Name:MCNEELA, EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:MCNEELA
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 1:307 S MILWAUKEE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5076
Mailing Address - Country:US
Mailing Address - Phone:847-465-8491
Mailing Address - Fax:847-465-8497
Practice Address - Street 1:307 S MILWAUKEE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5076
Practice Address - Country:US
Practice Address - Phone:847-465-8491
Practice Address - Fax:847-465-8497
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-005085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01682309OtherBC/BS OF ILLINOIS
IL747421Medicare PIN
ILT38462Medicare UPIN