Healthcare Provider Details

I. General information

NPI: 1063509727
Provider Name (Legal Business Name): MICHAEL LEE SILBERT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 W JACKSON BLVD SUITE A20
CHICAGO IL
60604-2929
US

IV. Provider business mailing address

141 W JACKSON BLVD SUITE A20
CHICAGO IL
60604-2929
US

V. Phone/Fax

Practice location:
  • Phone: 312-939-3400
  • Fax: 312-939-4986
Mailing address:
  • Phone: 312-939-3400
  • Fax: 312-939-4986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number042617698
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: