MEDICARE: DR. BRENT RASSI DC

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	038013463	IL

General Provider Information

NPI Number	:	1932744927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENT RASSI DC

Provider Business Mailing Address
First Line	:	125 BEHRENDS CT
Second Line	:
City	:	MORTON
State	:	IL
Zip	:	61550-2139
Country	:	US
Telephone Number	:	309-360-6037
Fax Number	:

Provider Business Practice Location Address
First Line	:	387 OLD GERMANTOWN RD
Second Line	:
City	:	GERMANTOWN HILLS
State	:	IL
Zip	:	61548-8679
Country	:	US
Telephone Number	:	309-383-2772
Fax Number	:

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

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	11/13/2019

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Directions to “ DR. BRENT RASSI DC” Practice Location

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