| Doctor Name: | MICHAEL EDWARD DECUBELLIS |
| NPI Number: | 1629222054 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DC |
| License Number: | 038-011235 |
| Business Practice Address: | 5157 Main St Suite 200 Downers Grove, IL - 605154616 |
| Business Phone Number: | 6304356461 |
| Business Fax Number: | 6309609924 |
| Mailing Address: | 5157 Main St, Suite 200 DOWNERS GROVE |
| State: | IL |
| Postal Code: | 605154616 |
| Phone Number: | 6304356461 |
| Fax Number: | 6309609924 |
| NPI Enumeration Date: | 11/12/2008 |
| NPI Last Update Date: | 03/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 038-011235 |
| 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. |