Provider Demographics
NPI:1891830329
Name:GIOVANIS, EMMANUEL (DC)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:GIOVANIS
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 1:40W222 LAFOX RD
Mailing Address - Street 2:UNIT G1
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-7625
Mailing Address - Country:US
Mailing Address - Phone:630-762-9415
Mailing Address - Fax:630-762-9416
Practice Address - Street 1:40W222 LAFOX RD
Practice Address - Street 2:UNIT G1
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-7625
Practice Address - Country:US
Practice Address - Phone:630-762-9415
Practice Address - Fax:630-762-9416
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004532069OtherBCBS PROVIDER #
IL0004532069OtherBCBS PROVIDER #
ILL94732Medicare UPIN