Provider Demographics
NPI:1730228313
Name:GARCIA, MARIO J (DC)
Entity type:Individual
Prefix:MR
First Name:MARIO
Middle Name:J
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 W DUNDEE RD
Mailing Address - Street 2:# 102
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3545
Mailing Address - Country:US
Mailing Address - Phone:847-243-0355
Mailing Address - Fax:847-243-0356
Practice Address - Street 1:333 W DUNDEE RD
Practice Address - Street 2:# 102
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3545
Practice Address - Country:US
Practice Address - Phone:847-243-0355
Practice Address - Fax:847-243-0356
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor