MEDICARE: LIMITLESS MEDICAL

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1760183560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMITLESS MEDICAL

Provider Business Mailing Address
First Line	:	4440 BROADWAY ST STE 12
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62305-9147
Country	:	US
Telephone Number	:	217-242-0420
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 BROADWAY ST STE 12
Second Line	:
City	:	QUINCY
State	:	IL
Zip	:	62305-9147
Country	:	US
Telephone Number	:	217-242-0420
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JUSTIN FELSMAN
Credential	:	DC
Telephone Number	:	217-242-0420

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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Directions to “LIMITLESS MEDICAL ” Practice Location

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