MEDICARE: DR. ERIC N POTOCKI DC

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
1	111N00000X	Chiropractor		IL

General Provider Information

NPI Number	:	1063529840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC N POTOCKI DC

Provider Business Mailing Address
First Line	:	25W330 GENEVA RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2328
Country	:	US
Telephone Number	:	630-310-0680
Fax Number	:

Provider Business Practice Location Address
First Line	:	25W330 GENEVA RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2328
Country	:	US
Telephone Number	:	630-310-0680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. ERIC N POTOCKI DC” Practice Location

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