Individual provider · Type 1 NPI

Glen John Nisivoccia, D C

Chiropractor · Mokena, IL

NPI number 1689684979 Active

Practice location

19600 La Grange Rd
Mokena, IL 60448-9321

Call (708) 478-3000 Map

Fax (708) 478-3007

Mailing address

13129 Hidden Valley Dr
Homer Glen, IL 60491-8486

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000X038004843 (IL)

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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About NPI 1689684979

Glen John Nisivoccia, D C's National Provider Identifier is 1689684979, issued on Aug 9, 2006. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Mokena, IL. The record was last updated on Jun 17, 2008.