MEDICARE: ARLINGTON CHIROPRACTIC CLINIC, P.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	111NN1001X	Nutrition Chiropractor
2	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1616245	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1467491852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON CHIROPRACTIC CLINIC, P.C.

Provider Business Mailing Address
First Line	:	1702 W CAMPBELL ST
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1518
Country	:	US
Telephone Number	:	847-259-4493
Fax Number	:	847-259-2242

Provider Business Practice Location Address
First Line	:	1702 W CAMPBELL ST
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1518
Country	:	US
Telephone Number	:	847-259-4493
Fax Number	:	847-259-2242

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GERALD T ANDREOLI
Credential	:	D.C.
Telephone Number	:	847-259-4493

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	05/27/2015

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Directions to “ARLINGTON CHIROPRACTIC CLINIC, P.C. ” Practice Location

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