MEDICARE: HEALTHWORKS INTEGRATIVE MEDICAL CLINIC

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	207Q00000X	Family Medicine Physician	336-042392	IL

General Provider Information

NPI Number	:	1073799771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWORKS INTEGRATIVE MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	1165 N CLARK ST
Second Line	:	SUITE 608
City	:	CHICAGO
State	:	IL
Zip	:	60610-2702
Country	:	US
Telephone Number	:	312-255-9444
Fax Number	:	312-255-9446

Provider Business Practice Location Address
First Line	:	1165 N CLARK ST
Second Line	:	SUITE 608
City	:	CHICAGO
State	:	IL
Zip	:	60610-2702
Country	:	US
Telephone Number	:	312-255-9444
Fax Number	:	312-255-9446

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. DAVID J. ZEIGER
Credential	:	D.O.
Telephone Number	:	312-255-9444

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	01/14/2008

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