MEDICARE: DR. ADAM M HUTTON 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	111NR0400X	Rehabilitation Chiropractor	38010799	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001636642	OTHER	IL	BCBS OF ILLINOIS
2	AZ0197150	OTHER	AZ	BLUE CROSS/ BLUE SHIELD

General Provider Information

NPI Number	:	1295743573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM M HUTTON D.C.

Provider Business Mailing Address
First Line	:	216 W NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-2413
Country	:	US
Telephone Number	:	847-776-5101
Fax Number	:	847-776-5103

Provider Business Practice Location Address
First Line	:	216 W NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-2413
Country	:	US
Telephone Number	:	847-776-5101
Fax Number	:	847-776-5103

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	09/25/2013

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