MEDICARE: PLANET HEALTH, PC

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	038008819	IL

General Provider Information

NPI Number	:	1174787493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANET HEALTH, PC

Provider Business Mailing Address
First Line	:	3925 75TH ST STE 102
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-8001
Country	:	US
Telephone Number	:	630-251-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 75TH ST STE 102
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-8001
Country	:	US
Telephone Number	:	630-251-0055
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHARLES MAJORS
Credential	:
Telephone Number	:	630-251-0055

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	04/10/2009

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