MEDICARE: NAPRAPATHY, INTEGRATIVE HEALTH & WELLNESS INC

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	172P00000X	Naprapath	01006	NM
2	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	01006	NM
3	208100000X	Physical Medicine & Rehabilitation Physician	01006	NM
4	133N00000X	Nutritionist	181000386	IL
5	174400000X	Specialist	181000386	IL
6	172P00000X	Naprapath	181000386	IL

General Provider Information

NPI Number	:	1467856005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPRAPATHY, INTEGRATIVE HEALTH & WELLNESS INC

Provider Business Mailing Address
First Line	:	17 N WABASH AVE
Second Line	:	SUITE 450
City	:	CHICAGO
State	:	IL
Zip	:	60602-4704
Country	:	US
Telephone Number	:	312-285-2121
Fax Number	:	312-285-2985

Provider Business Practice Location Address
First Line	:	17 N WABASH AVE
Second Line	:	SUITE 450
City	:	CHICAGO
State	:	IL
Zip	:	60602-4704
Country	:	US
Telephone Number	:	312-285-2121
Fax Number	:	312-285-2985

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARY A CAVENDER
Credential	:	DN
Telephone Number	:	312-285-2121

Provider Enumeration Date	:	10/10/2014
Last Update Date	:	12/08/2015

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