Mary TM Dicerbo, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MARY TM DICERBO, PC

Doing business as

Wellness from the Inside Out Family Chiropractic

Practice address

765 Ela Rd
Suite 105
Lake Zurich, IL 60047-2385

Phone

(847) 550-1115

Fax

(847) 550-1117

NPI assigned

Apr 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary TM Dicerbo, DC

Title

Owner

Phone

(847) 550-1115

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wellness from the Inside Out Family Chiropractic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1770703100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ELA RD",
            "address_2": "SUITE 105",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472385",
            "telephone_number": "847-550-1115",
            "fax_number": "847-550-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ELA RD",
            "address_2": "SUITE 105",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472385",
            "telephone_number": "847-550-1115",
            "fax_number": "847-550-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY TM DICERBO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "DICERBO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "TM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-550-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04932472",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness from the Inside Out Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mallory Malone, ATC, LAT
• Marc S Kaplan DDS LTD (Village Dental Center)
• Kelly Anne Marini, PHARM D
• Mars Healthcare LLC (lake zurich open mri)
• Sara Mitterholzer Marx, LCPC, NCC
• Linda Mass
• Laura Matula
• Lauren McArdle, PH.D., ABSNP
• Michael John McGrady Sr., D.D.S.
• Kenneth J. McKenna

• Chiropractor in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.