Provider Demographics
NPI:1639149081
Name:GHELANI, KALPESH M (DC)
Entity Type:Individual
Prefix:DR
First Name:KALPESH
Middle Name:M
Last Name:GHELANI
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 1:233 S. WACKER DR.
Mailing Address - Street 2:LL1 BOX 54
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606
Mailing Address - Country:US
Mailing Address - Phone:312-879-1979
Mailing Address - Fax:312-879-1989
Practice Address - Street 1:233 S WACKER DR
Practice Address - Street 2:LL1 BOX 54
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-6306
Practice Address - Country:US
Practice Address - Phone:312-879-1979
Practice Address - Fax:312-879-1989
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009890111N00000X
MI2301008629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633038OtherBLUE CROSS BLUE SHIELD
ILU94877Medicare UPIN
IL208786Medicare ID - Type Unspecified