MEDICARE: DR. DARREN D HANCOCK D.C.

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		IL

General Provider Information

NPI Number	:	1164453684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN D HANCOCK D.C.

Provider Business Mailing Address
First Line	:	5331 W PENSACOLA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-1309
Country	:	US
Telephone Number	:	773-736-1181
Fax Number	:	773-736-1185

Provider Business Practice Location Address
First Line	:	3546 N NORA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-3617
Country	:	US
Telephone Number	:	773-736-1181
Fax Number	:	773-736-1185

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/08/2007

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