MEDICARE: DR. RAYMOND BAYLEY II 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	038-004912	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1618591	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1447315429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND BAYLEY II D.C.

Provider Business Mailing Address
First Line	:	6448 N CENTRAL AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-2935
Country	:	US
Telephone Number	:	773-774-9200
Fax Number	:	773-774-6589

Provider Business Practice Location Address
First Line	:	6448 N CENTRAL AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-2935
Country	:	US
Telephone Number	:	773-774-9200
Fax Number	:	773-774-6589

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	02/28/2012

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