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Contact Information

DEMETRIOS BOBOLOS, LAC
512 W BURLINGTON AVE
SUITE 104
LA GRANGE, IL60525-2221
 Phone: 708-469-7592
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for DEMETRIOS BOBOLOS · (Male)

NPI Number 1851701668
Status Active
Credentials LAC
Entity Individual
Enumeration date 05/01/2014
Last updated 05/01/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 198.001145
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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