MEDICARE: DR. LE MONT M FREEMAN 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	038008107	IL

General Provider Information

NPI Number	:	1184840985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LE MONT M FREEMAN DC

Provider Business Mailing Address
First Line	:	2144 S ARCHER AVE # B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1514
Country	:	US
Telephone Number	:	312-326-9160
Fax Number	:

Provider Business Practice Location Address
First Line	:	2144 S ARCHER AVE # B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1514
Country	:	US
Telephone Number	:	312-326-9160
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	11/28/2017

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