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NPI Code Detail

MEDICARE: PREFERRED PAIN CARE SPECIALISTS

MEDICARE: PREFERRED PAIN CARE SPECIALISTS
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
2111N00000XChiropractorIL

General Provider Information

NPI Number : 1982896023
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREFERRED PAIN CARE SPECIALISTS
Provider Business Mailing Address
First Line : 200 E CHICAGO AVE
Second Line :
City : WESTMONT
State : IL
Zip : 60559-1746
Country : US
Telephone Number : 773-936-0303
Fax Number : 773-581-5661
Provider Business Practice Location Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-936-0303
Fax Number : 773-581-5661
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROBERT E BUTT
Credential : D.C.
Telephone Number : 773-936-0303
Provider Enumeration Date : 08/13/2007
Last Update Date : 08/13/2007

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Directions to “PREFERRED PAIN CARE SPECIALISTS ” Practice Location

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