Provider Demographics
NPI:1851443329
Name:VELLER, BORIS (DC)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:VELLER
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 1:333 E IL ROUTE 83 STE B5
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4299
Mailing Address - Country:US
Mailing Address - Phone:224-432-7226
Mailing Address - Fax:
Practice Address - Street 1:333 E IL ROUTE 83 STE B5
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4299
Practice Address - Country:US
Practice Address - Phone:224-432-7226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011309111N00000X
IL038010408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor