MEDICARE: STILES CHIROPRACTIC OFFICES

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		IL

General Provider Information

NPI Number	:	1902096068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILES CHIROPRACTIC OFFICES

Provider Business Mailing Address
First Line	:	48 E CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2026
Country	:	US
Telephone Number	:	312-642-1138
Fax Number	:	312-642-1349

Provider Business Practice Location Address
First Line	:	48 E CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2026
Country	:	US
Telephone Number	:	312-642-1138
Fax Number	:	312-642-1349

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TRACEY D. STILES
Credential	:	D.C.
Telephone Number	:	312-642-1138

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	07/25/2007

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