Provider Demographics
NPI:1487290946
Name:PRENTIS, BIANCA (DC)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:PRENTIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:CATALANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6N276 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINAH
Mailing Address - State:IL
Mailing Address - Zip Code:60157-9729
Mailing Address - Country:US
Mailing Address - Phone:630-306-9028
Mailing Address - Fax:
Practice Address - Street 1:1640 CAPITAL ST STE 300
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60124-8077
Practice Address - Country:US
Practice Address - Phone:224-858-3288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty