MEDICARE: DR. JUANITA E DARBY 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
1	111N00000X	Chiropractor	038012708	IL

General Provider Information

NPI Number	:	1063617405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUANITA E DARBY DC

Provider Business Mailing Address
First Line	:	PO BOX 81765
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60681-0765
Country	:	US
Telephone Number	:	312-635-6242
Fax Number	:	312-635-2123

Provider Business Practice Location Address
First Line	:	800 S WELLS ST APT 1324
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4541
Country	:	US
Telephone Number	:	312-635-6242
Fax Number	:	312-635-2123

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2007
Last Update Date	:	05/14/2017

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