MEDICARE: DR. MOONESS TALEBNIA 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		IL

General Provider Information

NPI Number	:	1245320688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOONESS TALEBNIA D.C.

Provider Business Mailing Address
First Line	:	250 LAKE GILLILAN WAY
Second Line	:
City	:	ALGONQUIN
State	:	IL
Zip	:	60102-5015
Country	:	US
Telephone Number	:	847-658-1805
Fax Number	:	847-490-7066

Provider Business Practice Location Address
First Line	:	1007 W GOLF RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60194-1339
Country	:	US
Telephone Number	:	847-490-7000
Fax Number	:	847-490-7066

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

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	07/08/2007

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