MEDICARE: DR. LAUREL VELTE 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	038-004230	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7115575	OTHER	IL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700803434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREL VELTE D.C.

Provider Business Mailing Address
First Line	:	105 S LAFAYETTE ST
Second Line	:
City	:	BYRON
State	:	IL
Zip	:	61010-8970
Country	:	US
Telephone Number	:	815-234-3021
Fax Number	:	815-234-5580

Provider Business Practice Location Address
First Line	:	105 S LAFAYETTE ST
Second Line	:
City	:	BYRON
State	:	IL
Zip	:	61010-8970
Country	:	US
Telephone Number	:	815-234-3021
Fax Number	:	815-234-5580

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	09/08/2008

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Directions to “ DR. LAUREL VELTE D.C.” Practice Location

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