MEDICARE: ALLIED HEALTH, P.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	038008417	IL

General Provider Information

NPI Number	:	1194984625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED HEALTH, P.C.

Provider Business Mailing Address
First Line	:	545 N LAKE ST
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1826
Country	:	US
Telephone Number	:	815-404-3727
Fax Number	:

Provider Business Practice Location Address
First Line	:	36181 E LAKE RD STE 300
Second Line	:	STE. 300
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3142
Country	:	US
Telephone Number	:	815-404-3727
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	WENDY KUST
Credential	:
Telephone Number	:	815-404-3727

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	04/27/2009

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