MEDICARE: ALTERNATIVE HEALTHCARE OF BEVERLY HILLS CHICAGO, INC.

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	111NX0800X	Orthopedic Chiropractor	038-008140	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	038-008140	OTHER	IL	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1467613778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE HEALTHCARE OF BEVERLY HILLS CHICAGO, INC.

Provider Business Mailing Address
First Line	:	4248 BELLE AIRE LN
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1914
Country	:	US
Telephone Number	:	630-324-4763
Fax Number	:

Provider Business Practice Location Address
First Line	:	9948 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1831
Country	:	US
Telephone Number	:	773-445-6800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HUGH A. JENKINS
Credential	:	D.C.
Telephone Number	:	773-445-6800

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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