Provider Demographics
NPI:1992105308
Name:BERARDINO-SKWIRBLIES, MARIE (DC)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:BERARDINO-SKWIRBLIES
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 1:1845 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-1148
Mailing Address - Country:US
Mailing Address - Phone:847-885-8808
Mailing Address - Fax:847-885-9006
Practice Address - Street 1:1845 W GOLF RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-1148
Practice Address - Country:US
Practice Address - Phone:847-885-8808
Practice Address - Fax:847-885-9006
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.008958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor