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NPI Code Detail

MEDICARE: HEALTHSMART OF ILLINOIS, LTD.

MEDICARE: HEALTHSMART OF ILLINOIS, LTD.
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
1111N00000XChiropractorIL

General Provider Information

NPI Number : 1972771400
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHSMART OF ILLINOIS, LTD.
Provider Business Mailing Address
First Line : 2565 SHERMER RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-6725
Country : US
Telephone Number : 847-272-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2565 SHERMER RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-6725
Country : US
Telephone Number : 847-272-1000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARSHALL DICKHOLTZ JR.
Credential : DC
Telephone Number : 847-272-1000
Provider Enumeration Date : 02/19/2008
Last Update Date : 02/19/2008

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Directions to “HEALTHSMART OF ILLINOIS, LTD. ” Practice Location

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