Doctor Name: | GREGORY R POLOVICH |
NPI Number: | 1023027216 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 038-004196 |
Business Practice Address: | 915 W Spresser St Taylorville, IL - 625681831 |
Business Phone Number: | 2178246222 |
Business Fax Number: | 2178245511 |
Mailing Address: | 823 Mesa Verde Ct, TAYLORVILLE |
State: | IL |
Postal Code: | 625689103 |
Phone Number: | 2178246222 |
Fax Number: | 2178245511 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 05/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 038-004196 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |