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General NPI Number Information
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NPI Number | 1194087767
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Entity Type | Organization
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Legal Business Name | MEDICAL ELEMENT, SC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 233 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60610-4637
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Country | US
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Telephone | 312-229-0031
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Fax | 312-948-9193
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Provider Business Mailing Address
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Address Line | 233 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60610-4637
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Country | US
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Telephone | 312-229-0031
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Fax | 312-948-9193
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALI B RAFIE
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Credential | D.C.
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Telephone | 312-229-0031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038010642
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038008248
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License Number State | IL
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