MEDICARE: KIND CARE HEALTH

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	038.011767	IL

General Provider Information

NPI Number	:	1215237011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIND CARE HEALTH

Provider Business Mailing Address
First Line	:	4236 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-1605
Country	:	US
Telephone Number	:	773-545-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	4236 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-1605
Country	:	US
Telephone Number	:	773-545-3700
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SALMA MITHA
Credential	:	DC
Telephone Number	:	704-789-3363

Provider Enumeration Date	:	10/26/2010
Last Update Date	:	10/27/2010

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Directions to “KIND CARE HEALTH ” Practice Location

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