MEDICARE: DR. SHANNA C FRITSCH 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	038-010678	IL

General Provider Information

NPI Number	:	1336213149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANNA C FRITSCH D.C.

Provider Business Mailing Address
First Line	:	2556 W CORTLAND ST
Second Line	:	2F
City	:	CHICAGO
State	:	IL
Zip	:	60647-4370
Country	:	US
Telephone Number	:	815-793-2951
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 E WACKER PL
Second Line	:	SUITE 1615
City	:	CHICAGO
State	:	IL
Zip	:	60601-7296
Country	:	US
Telephone Number	:	815-793-2951
Fax Number	:

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	06/19/2008

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