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NPI Code Detail

MEDICARE: DR. KATERI ASHVIN PORTO DC

MEDICARE: DR. KATERI ASHVIN PORTO 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
1111N00000XChiropractor038011714IL

General Provider Information

NPI Number : 1093023640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATERI ASHVIN PORTO DC
Provider Business Mailing Address
First Line : 2720 S HIGHLAND AVE
Second Line : SUITE 767
City : LOMBARD
State : IL
Zip : 60148-5302
Country : US
Telephone Number : 630-306-8177
Fax Number :
Provider Business Practice Location Address
First Line : 2720 SOUTH HIGHLAND AVE
Second Line : SUITE 767
City : LOMBARD
State : IL
Zip : 60148-4539
Country : US
Telephone Number : 630-306-8177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2010
Last Update Date : 02/09/2011

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