MEDICARE: ROSENBERG CHIROPRACTIC CENTER

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	213306	OTHER	IL	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1682549	OTHER	IL	BCBSIL

General Provider Information

NPI Number	:	1285603175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSENBERG CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	504 N PLUM GROVE RD
Second Line	:	SUITE C
City	:	PALATINE
State	:	IL
Zip	:	60067-8207
Country	:	US
Telephone Number	:	847-358-0010
Fax Number	:	847-358-8244

Provider Business Practice Location Address
First Line	:	504 N PLUM GROVE RD
Second Line	:	SUITE C
City	:	PALATINE
State	:	IL
Zip	:	60067-8207
Country	:	US
Telephone Number	:	847-358-0010
Fax Number	:	847-358-8244

Authorized Official
Title or Position	:	OWNER
Name	:	SONNY ROSENBERG
Credential	:	D.C.
Telephone Number	:	847-358-0010

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	10/19/2007

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Directions to “ROSENBERG CHIROPRACTIC CENTER ” Practice Location

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