MEDICARE: DR. TRAVIS J AHRENS 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	38.012838	IL

General Provider Information

NPI Number	:	1376977769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRAVIS J AHRENS D.C.

Provider Business Mailing Address
First Line	:	233 E WACKER DR
Second Line	:	1402
City	:	CHICAGO
State	:	IL
Zip	:	60601-5104
Country	:	US
Telephone Number	:	920-410-8728
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 E WACKER DR
Second Line	:	1402
City	:	CHICAGO
State	:	IL
Zip	:	60601-5104
Country	:	US
Telephone Number	:	920-410-8728
Fax Number	:

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

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	02/09/2016

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