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NPI Code Detail

MEDICARE: SIMONE WASHINGTON DC

MEDICARE:   SIMONE  WASHINGTON  DC
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
1111N00000XChiropractor038-011451IL

General Provider Information

NPI Number : 1043591217
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIMONE WASHINGTON DC
Provider Business Mailing Address
First Line : PO BOX 5977
Second Line : DEPT 203052
City : CAROL STREAM
State : IL
Zip : 60197-5977
Country : US
Telephone Number : 630-754-8788
Fax Number : 630-754-8792
Provider Business Practice Location Address
First Line : 4030 N. CICERO
Second Line :
City : CHICAGO
State : IL
Zip : 60641-1807
Country : US
Telephone Number : 773-557-7766
Fax Number : 773-557-7767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2011
Last Update Date : 06/20/2012

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Directions to “ SIMONE WASHINGTON DC” Practice Location

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