Healthcare Provider Details

I. General information

NPI: 1609900489
Provider Name (Legal Business Name): K & E MEDICAL LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S WESTERN AVE
CHICAGO IL
60612-3531
US

IV. Provider business mailing address

600 S WESTERN AVE
CHICAGO IL
60612-3531
US

V. Phone/Fax

Practice location:
  • Phone: 312-243-3411
  • Fax: 312-733-8381
Mailing address:
  • Phone: 312-243-3411
  • Fax: 312-733-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number042006313
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036056245
License Number StateIL

VIII. Authorized Official

Name: DR. ELLIOTT MATTHEW CHAY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 312-243-3411