MEDICARE: DR. MICHAEL PATRICK BARTELL 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	CHR0006933	CO
2	111N00000X	Chiropractor	038-007339	IL
3	111N00000X	Chiropractor	5921	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4527478	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1184720229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL PATRICK BARTELL D.C.

Provider Business Mailing Address
First Line	:	400 VIRGINIA AVE STE 114
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-3477
Country	:	US
Telephone Number	:	630-205-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 VIRGINIA AVE STE 114
Second Line	:
City	:	NORTH BEND
State	:	OR
Zip	:	97459-3477
Country	:	US
Telephone Number	:	541-808-9697
Fax Number	:	541-808-9699

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	01/12/2021

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