MEDICARE: DR. CHRISTA BAVARO 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	038008349	IL

General Provider Information

NPI Number	:	1376585265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTA BAVARO D.C.

Provider Business Mailing Address
First Line	:	1702 W CAMPBELL ST
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-1518
Country	:	US
Telephone Number	:	847-259-4493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 W CAMPBELL ST
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-1518
Country	:	US
Telephone Number	:	847-259-4493
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	10/27/2010

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