MEDICARE: TESKE FAMILY CHIROPRACTIC CENTER 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	042617033	IL

General Provider Information

NPI Number	:	1447439849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TESKE FAMILY CHIROPRACTIC CENTER LTD

Provider Business Mailing Address
First Line	:	425 S GOVERNORS HWY
Second Line	:	PO BOX 848
City	:	PEOTONE
State	:	IL
Zip	:	60468-9116
Country	:	US
Telephone Number	:	708-258-3965
Fax Number	:	708-258-6640

Provider Business Practice Location Address
First Line	:	425 S GOVERNORS HWY
Second Line	:
City	:	PEOTONE
State	:	IL
Zip	:	60468-9116
Country	:	US
Telephone Number	:	708-258-3965
Fax Number	:	708-258-6640

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRENDA TESKE
Credential	:	D.C.
Telephone Number	:	708-258-3965

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	01/19/2016

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