Provider Demographics
NPI:1336829241
Name:MARANAN, ANJELICA CARMEL B (DC)
Entity type:Individual
Prefix:
First Name:ANJELICA CARMEL
Middle Name:B
Last Name:MARANAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 BRADLEY CIR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2399
Mailing Address - Country:US
Mailing Address - Phone:847-971-5981
Mailing Address - Fax:
Practice Address - Street 1:2210 CAMDEN CT STE 1E
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4671
Practice Address - Country:US
Practice Address - Phone:630-791-5263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor