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NPI Code Detail

MEDICARE: DR. JOHN J BAIETTI D.C.

MEDICARE:  DR. JOHN J BAIETTI  D.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
1111N00000XChiropractor038-007280IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101605502OTHERILBLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number : 1154453330
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN J BAIETTI D.C.
Provider Business Mailing Address
First Line : 6804 W ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-2312
Country : US
Telephone Number : 773-586-2340
Fax Number : 773-586-2368
Provider Business Practice Location Address
First Line : 6804 W ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-2312
Country : US
Telephone Number : 773-586-2340
Fax Number : 773-586-2368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 07/31/2012

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Directions to “ DR. JOHN J BAIETTI D.C.” Practice Location

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