MEDICARE: GIFFEN SPINAL CARE, LTD

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	038008526	IL

General Provider Information

NPI Number	:	1447576202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFFEN SPINAL CARE, LTD

Provider Business Mailing Address
First Line	:	600 N 1ST BANK DR
Second Line	:	SUITE B
City	:	PALATINE
State	:	IL
Zip	:	60067-8185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N 1ST BANK DR
Second Line	:	SUITE B
City	:	PALATINE
State	:	IL
Zip	:	60067-8185
Country	:	US
Telephone Number	:	847-963-9697
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRUCE WARD GIFFEN
Credential	:	D.C.
Telephone Number	:	847-963-9697

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	04/19/2010

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Directions to “GIFFEN SPINAL CARE, LTD ” Practice Location

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