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NPI Code Detail

MEDICARE: MARY J DOXAS DC

MEDICARE: MARY J DOXAS DC
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101682688OTHERILBCBSIL

General Provider Information

NPI Number : 1285603274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J DOXAS DC
Provider Business Mailing Address
First Line : 3423 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1536
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3423 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1536
Country : US
Telephone Number : 847-577-5774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/08/2007

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Directions to “ MARY J DOXAS DC” Practice Location

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