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General NPI Number Information
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NPI Number | 1346571361
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Entity Type | Organization
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Legal Business Name | MEDICAL INTEGRATION SC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 4920 N CENTRAL AVE SUITE 1A
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City | CHICAGO
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State | IL
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Zip | 60630-2338
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Country | US
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Telephone | 773-427-0820
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Fax | 773-427-0825
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Provider Business Mailing Address
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Address Line | 4920 N CENTRAL AVE SUITE 1A
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City | CHICAGO
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State | IL
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Zip | 60630-2338
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Country | US
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Telephone | 773-427-0820
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Fax | 773-427-0825
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Authorized Official
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Title or Position | CLINIC DIRECTOR/PRESIDENT
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Name | DR. LOUIS MARK LUNA
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Credential | D.C.
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Telephone | 17736193611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 038-010483
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License Number State | IL
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