MEDICARE: DR. THOMAS MICHAEL HALWAX 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
1	111N00000X	Chiropractor	0380005233	IL
2	111N00000X	Chiropractor	4745	FL
3	111N00000X	Chiropractor	08000995	IN

General Provider Information

NPI Number	:	1215937123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS MICHAEL HALWAX D.C.

Provider Business Mailing Address
First Line	:	15348 RIDGELAND AVE
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-1619
Country	:	US
Telephone Number	:	708-687-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	15348 RIDGELAND AVE
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-1619
Country	:	US
Telephone Number	:	708-687-2724
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	08/04/2012

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