MEDICARE: CHICAGO MEDICAL & PAIN ASSOC 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	038010386	IL

General Provider Information

NPI Number	:	1558433854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO MEDICAL & PAIN ASSOC LTD

Provider Business Mailing Address
First Line	:	630 N FRANKLIN ST
Second Line	:	SUITE 801
City	:	CHICAGO
State	:	IL
Zip	:	60610-8327
Country	:	US
Telephone Number	:	773-358-8600
Fax Number	:	773-585-5980

Provider Business Practice Location Address
First Line	:	3535 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-2417
Country	:	US
Telephone Number	:	773-227-1717
Fax Number	:	773-227-0202

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. IAN R BELTON
Credential	:	D.C.
Telephone Number	:	760-271-6872

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/03/2008

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