Provider Demographics
NPI:1487744520
Name:MANI, ARUN G (DC)
Entity type:Individual
Prefix:DR
First Name:ARUN
Middle Name:G
Last Name:MANI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:453 DUNHAM RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1451
Mailing Address - Country:US
Mailing Address - Phone:630-587-5824
Mailing Address - Fax:630-587-5834
Practice Address - Street 1:1250 EXECUTIVE PL
Practice Address - Street 2:STE 402
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3807
Practice Address - Country:US
Practice Address - Phone:630-208-8244
Practice Address - Fax:630-845-9522
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038-009381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038009381Medicaid
ILU97998Medicare UPIN
ILK02792Medicare ID - Type Unspecified
IL038009381Medicaid