MEDICARE: SERENITY FAMILY CHIROPRACTIC PLLC

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	171100000X	Acupuncturist
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1245050194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY FAMILY CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	6321 N AVONDALE AVE STE A108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1900
Country	:	US
Telephone Number	:	224-587-0129
Fax Number	:

Provider Business Practice Location Address
First Line	:	6321 N AVONDALE AVE STE A108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1900
Country	:	US
Telephone Number	:	224-587-0129
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	ERICA JURIS
Credential	:	DC
Telephone Number	:	224-587-0129

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	10/15/2024

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Directions to “SERENITY FAMILY CHIROPRACTIC PLLC ” Practice Location

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