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NPI Code Detail

MEDICARE: WEBER MICETICH CHIROPRACTIC P.C.

MEDICARE: WEBER MICETICH CHIROPRACTIC P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor038007825IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2212905OTHERILMEDICARE PTAN
3350054286OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13232036OTHERILBLUE CROSS BLUE SHIELD IL

General Provider Information

NPI Number : 1003933300
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBER MICETICH CHIROPRACTIC P.C.
Provider Business Mailing Address
First Line : 24 E NORTH ST
Second Line :
City : COAL CITY
State : IL
Zip : 60416-1087
Country : US
Telephone Number : 815-634-0445
Fax Number : 815-634-3188
Provider Business Practice Location Address
First Line : 24 E NORTH ST
Second Line :
City : COAL CITY
State : IL
Zip : 60416-1087
Country : US
Telephone Number : 815-634-0445
Fax Number : 815-634-3188
Authorized Official
Title or Position : OWNER
Name : DR. JULI WEBER-MICETICH
Credential : DC
Telephone Number : 815-634-0445
Provider Enumeration Date : 03/23/2007
Last Update Date : 04/21/2015

Similar Medicare Providers

1467454587 — DR. JULI WEBER MICETICH D.C.
Practice Location Address:
24 E NORTH ST
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60416-1087
Practice Phone: 815-634-0445
Practice Fax:
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1740273754 — DR. JONATHAN EDWARD MICETICH O.D.
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COAL CITY, IL
60416-1087
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Practice Fax: 815-634-4938
1093832008 — J. MICETICH, OD & ASSOCIATES FAMILY EYE CARE CENTER P C
Practice Location Address:
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60416-1087
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Practice Fax:
1487948964 — LIBERTY MEDICAL CENTER COAL CITY SC
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1689916058 — AAMAIR TAJUDDIN D.O.
Practice Location Address:
4 E NORTH ST
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Practice Phone: 815-518-5755
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Directions to “WEBER MICETICH CHIROPRACTIC P.C. ” Practice Location

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