MEDICARE: TITAN MEDICAL ASSOCIATES LTD.

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1407571664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITAN MEDICAL ASSOCIATES LTD.

Provider Business Mailing Address
First Line	:	1361 PHEASANT TRL
Second Line	:
City	:	HAMPSHIRE
State	:	IL
Zip	:	60140-7413
Country	:	US
Telephone Number	:	224-535-8707
Fax Number	:	224-535-8743

Provider Business Practice Location Address
First Line	:	999 W MAIN ST STE 100
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-2082
Country	:	US
Telephone Number	:	224-535-8707
Fax Number	:	224-535-8743

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS MITCHELL
Credential	:	DC
Telephone Number	:	630-346-3600

Provider Enumeration Date	:	10/10/2022
Last Update Date	:	10/10/2022

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