MEDICARE: COMMUNITY CHIROPRACTIC, 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	111N00000X	Chiropractor	038-007640	IL

General Provider Information

NPI Number	:	1740210400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	1442 W. BELMONT AVE.
Second Line	:	SUITE 1E
City	:	CHICAGO
State	:	IL
Zip	:	60657-3204
Country	:	US
Telephone Number	:	773-528-8485
Fax Number	:

Provider Business Practice Location Address
First Line	:	1442 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-9422
Country	:	US
Telephone Number	:	773-528-8485
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHANIE A MAJ
Credential	:	D.C.
Telephone Number	:	773-528-8485

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/22/2013

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