Provider Demographics
NPI:1407159262
Name:PECHO, GARY A (LAC, MSOM)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:A
Last Name:PECHO
Suffix:
Gender:M
Credentials:LAC, MSOM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1323 BUTTERFIELD RD STE 102
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5620
Mailing Address - Country:US
Mailing Address - Phone:331-343-3140
Mailing Address - Fax:331-343-3233
Practice Address - Street 1:1323 BUTTERFIELD RD STE 102
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5620
Practice Address - Country:US
Practice Address - Phone:331-343-3140
Practice Address - Fax:331-343-3233
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000921171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist