MEDICARE: DR. CATHY LYNN DZIK 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
1	111N00000X	Chiropractor	038009050	IL

General Provider Information

NPI Number	:	1417921610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHY LYNN DZIK DC

Provider Business Mailing Address
First Line	:	1820 WINDOR RD
Second Line	:	SUITE A
City	:	LOVES PARK
State	:	IL
Zip	:	61111
Country	:	US
Telephone Number	:	815-986-4411
Fax Number	:	815-986-4414

Provider Business Practice Location Address
First Line	:	1820 WINDSOR RD
Second Line	:	SUITE A
City	:	LOVES PARK
State	:	IL
Zip	:	61111-4271
Country	:	US
Telephone Number	:	815-986-4411
Fax Number	:	815-986-4414

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	09/29/2015

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