Provider Demographics
NPI:1649340720
Name:CHATELLIER, ARTHUR JOHN III (DC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:JOHN
Last Name:CHATELLIER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N PEACE RD STE C
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-8401
Mailing Address - Country:US
Mailing Address - Phone:815-748-3102
Mailing Address - Fax:815-748-7433
Practice Address - Street 1:650 N PEACE RD STE C
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-8401
Practice Address - Country:US
Practice Address - Phone:815-748-3102
Practice Address - Fax:815-748-7433
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1154111N00000X
IAA06057111N00000X
IL038008193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038008193Medicaid
IL440630Medicare ID - Type Unspecified
IL038008193Medicaid