Provider Demographics
NPI:1750465969
Name:PUSATERI, THOMAS G (DC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:G
Last Name:PUSATERI
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 1:1560 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-1575
Mailing Address - Country:US
Mailing Address - Phone:847-934-4144
Mailing Address - Fax:847-934-4159
Practice Address - Street 1:1560 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-1575
Practice Address - Country:US
Practice Address - Phone:847-934-4144
Practice Address - Fax:847-934-4159
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0380003967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL616831OtherMEDICARE