Provider Demographics
NPI:1972819274
Name:NOTTOLI, PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:NOTTOLI
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 1:4327 BAYHEAD CT
Mailing Address - Street 2:APT. 2C
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5081
Mailing Address - Country:US
Mailing Address - Phone:563-340-1552
Mailing Address - Fax:
Practice Address - Street 1:768 SHORELINE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6192
Practice Address - Country:US
Practice Address - Phone:563-340-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor