Provider Demographics
NPI:1922192129
Name:TRONOLONE, RICHARD J (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:TRONOLONE
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 1:906 LACEY AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1318
Mailing Address - Country:US
Mailing Address - Phone:630-964-5600
Mailing Address - Fax:630-964-0600
Practice Address - Street 1:906 LACEY AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1318
Practice Address - Country:US
Practice Address - Phone:630-964-5600
Practice Address - Fax:630-964-0600
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02290116OtherBC/BS
IL940290Medicare ID - Type Unspecified