MEDICARE: DR. SHERRY LYNN BRESNAHAN 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	038-009231	IL

General Provider Information

NPI Number	:	1336379882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERRY LYNN BRESNAHAN D.C.

Provider Business Mailing Address
First Line	:	330 HIAWATHA DR
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-1421
Country	:	US
Telephone Number	:	847-658-5828
Fax Number	:	847-658-5861

Provider Business Practice Location Address
First Line	:	330 HIAWATHA DR
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-1421
Country	:	US
Telephone Number	:	847-658-5828
Fax Number	:	847-658-5861

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

Provider Enumeration Date	:	07/17/2009
Last Update Date	:	07/17/2009

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