MEDICARE: MICHAEL L BELBA DC 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		IL

General Provider Information

NPI Number	:	1194993048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL L BELBA DC PC

Provider Business Mailing Address
First Line	:	3207 LAKE AVE
Second Line	:	SUITE 5A
City	:	WILMETTE
State	:	IL
Zip	:	60091-1082
Country	:	US
Telephone Number	:	847-920-1822
Fax Number	:	847-920-1823

Provider Business Practice Location Address
First Line	:	3207 LAKE AVE
Second Line	:	SUITE 5A
City	:	WILMETTE
State	:	IL
Zip	:	60091-1082
Country	:	US
Telephone Number	:	847-920-1822
Fax Number	:	847-920-1823

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL LOUIS BELBA
Credential	:	D.C.
Telephone Number	:	847-920-1822

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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