MEDICARE: DR. TINA M. TAYLOR DN

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	172P00000X	Naprapath	181000230	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001625785	OTHER	IL	BCBS PROVIDER #

General Provider Information

NPI Number	:	1134277395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA M. TAYLOR DN

Provider Business Mailing Address
First Line	:	8733 S WINCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5451
Country	:	US
Telephone Number	:	773-298-1220
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W 76TH ST
Second Line	:	SUITE 210
City	:	CHICAGO
State	:	IL
Zip	:	60620-1640
Country	:	US
Telephone Number	:	773-873-5000
Fax Number	:

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

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	06/16/2009

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