MEDICARE: THOMAS MITCHELL 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	038009968	IL

General Provider Information

NPI Number	:	1336194679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS MITCHELL DC

Provider Business Mailing Address
First Line	:	999 W MAIN ST
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-2082
Country	:	US
Telephone Number	:	224-535-8707
Fax Number	:	224-535-8743

Provider Business Practice Location Address
First Line	:	999 W MAIN ST
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-2082
Country	:	US
Telephone Number	:	847-428-8850
Fax Number	:

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/15/2020

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Directions to “ THOMAS MITCHELL DC” Practice Location

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