Provider Demographics
NPI:1386948784
Name:PUGLIESE, ANTONIO F (DN)
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:F
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2020
Mailing Address - Country:US
Mailing Address - Phone:708-308-8669
Mailing Address - Fax:708-452-6043
Practice Address - Street 1:2502 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-2020
Practice Address - Country:US
Practice Address - Phone:708-308-8669
Practice Address - Fax:708-452-6043
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000237171100000X, 172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
No171100000XOther Service ProvidersAcupuncturist