MEDICARE: JOHN LEONARD GUILD 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	:	1184785560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN LEONARD GUILD DC

Provider Business Mailing Address
First Line	:	117 S EAST ST
Second Line	:
City	:	CAMBRIDGE
State	:	IL
Zip	:	61238-1221
Country	:	US
Telephone Number	:	309-937-5391
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 S EAST ST
Second Line	:	CAMBRIDGE CHIROPRACTIC
City	:	CAMBRIDGE
State	:	IL
Zip	:	61238-1221
Country	:	US
Telephone Number	:	309-937-5391
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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