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NPI Code Detail

MEDICARE: DR. ALYSSA HOLUM DC

MEDICARE: DR. ALYSSA HOLUM 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
1111NI0013XIndependent Medical Examiner Chiropractor038.013430IL

General Provider Information

NPI Number : 1356987168
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSSA HOLUM DC
Provider Business Mailing Address
First Line : 543 HAMILTON AVE
Second Line :
City : WESTMONT
State : IL
Zip : 60559-1274
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W NORTHWEST HWY
Second Line :
City : PALATINE
State : IL
Zip : 60067-1837
Country : US
Telephone Number : 847-496-4567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2019
Last Update Date : 11/27/2019

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