Provider Demographics
NPI:1629091319
Name:VALIO, GINA M, (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:M,
Last Name:VALIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BANBURY LN
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9355
Mailing Address - Country:US
Mailing Address - Phone:630-302-2530
Mailing Address - Fax:217-355-1024
Practice Address - Street 1:2309 VILLAGE GREEN PL
Practice Address - Street 2:SUITE B
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822
Practice Address - Country:US
Practice Address - Phone:217-355-9900
Practice Address - Fax:217-355-1024
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36-3884650Medicare UPIN
IL327990Medicare ID - Type Unspecified