MEDICARE: SIGLER CHIROPRACTIC CLINIC, S.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	038.011086	IL

General Provider Information

NPI Number	:	1407087380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGLER CHIROPRACTIC CLINIC, S.C.

Provider Business Mailing Address
First Line	:	903 W 3RD ST
Second Line	:
City	:	MOUNT CARMEL
State	:	IL
Zip	:	62863-1718
Country	:	US
Telephone Number	:	618-262-8517
Fax Number	:	618-262-8842

Provider Business Practice Location Address
First Line	:	903 W 3RD ST
Second Line	:
City	:	MOUNT CARMEL
State	:	IL
Zip	:	62863-1718
Country	:	US
Telephone Number	:	618-262-8517
Fax Number	:	618-262-8842

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JASON WADE SIGLER
Credential	:	D.C.
Telephone Number	:	618-262-8517

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	08/03/2009

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