MEDICARE: ATLAS CHIROPRACTIC HEALTH CENTER, 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	111NS0005X	Sports Physician Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CM00104093	OTHER	IL	MALPRACTICE POLICY NUMBER
2	1124101746	OTHER	IL	DR. JAMES J. MICHAELS NPI

General Provider Information

NPI Number	:	1538248596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS CHIROPRACTIC HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	3178 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4509
Country	:	US
Telephone Number	:	773-549-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3178 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4509
Country	:	US
Telephone Number	:	773-549-6400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES JAY MICHAELS
Credential	:	D.C.
Telephone Number	:	773-549-6400

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/22/2020

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