MEDICARE: OLD IRVING CHIROPRACTIC & WELLNESS CENTER, LLC

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	038-010362	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11628176	OTHER	IL	CAQH

General Provider Information

NPI Number	:	1063680825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLD IRVING CHIROPRACTIC & WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	4337 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2830
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4337 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2830
Country	:	US
Telephone Number	:	713-410-3776
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DAPHNE ROSCOE
Credential	:	D.C.
Telephone Number	:	713-410-3776

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	06/16/2008

Similar Medicare Providers

1972618320 — DR. JASON EDWARD BURNS DN
Practice Location Address:

4337 W IRVING PARK RD
CHICAGO, IL
60641-2830

Practice Phone: 773-205-6572
Practice Fax:

1144419623 — DR. DAPHNE ROSCOE D.C.
Practice Location Address:

4337 W IRVING PARK RD
CHICAGO, IL
60641-2830

Practice Phone: 713-410-3776
Practice Fax:

1356115018 — THE ART OF BEING PLLC
Practice Location Address:

4337 W IRVING PARK RD
CHICAGO, IL
60641-2830

Practice Phone: 773-255-1420
Practice Fax:

1972318285 — SATYAVATI PATEL LCP
Practice Location Address:

4337 W IRVING PARK RD
CHICAGO, IL
60641-2830

Practice Phone: 773-255-1420
Practice Fax:

1124055835 — CHRISTINE J SCHAEFFER MD
Practice Location Address:

676 N SAINT CLAIR ST STE 2030
CHICAGO, IL
60611-2830

Practice Phone: 773-562-3642
Practice Fax: 312-926-2200

1114955622 — MIDWEST RADIOLOGY ASSOCIATES SC
Practice Location Address:

6130 N SHERIDAN RD , VENCOR HOSPITAL - LAKESHORE
CHICAGO, IL
60660-2830

Practice Phone: 773-736-7000
Practice Fax:

Directions to “OLD IRVING CHIROPRACTIC & WELLNESS CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.