Provider Demographics
NPI:1801017405
Name:METCALF, HANDEL A (DC)
Entity type:Individual
Prefix:DR
First Name:HANDEL
Middle Name:A
Last Name:METCALF
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:BOX 2601
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60507-2601
Mailing Address - Country:US
Mailing Address - Phone:630-844-1900
Mailing Address - Fax:
Practice Address - Street 1:458 N.LAKE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60507
Practice Address - Country:US
Practice Address - Phone:630-844-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03804476111NN0400X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0004582052OtherBLUE CROSS
IL212888Medicaid
212888Medicare PIN