MEDICARE: CHIROPRACTIC FAMILY HEALTH CLINIC WD LLC

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	038012388	IL

General Provider Information

NPI Number	:	1518339464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC FAMILY HEALTH CLINIC WD LLC

Provider Business Mailing Address
First Line	:	650 SPRING HILL RING RD
Second Line	:	SUITE 2005
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1297
Country	:	US
Telephone Number	:	847-844-7900
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 SPRING HILL RING RD
Second Line	:	SUITE 2005
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1297
Country	:	US
Telephone Number	:	847-844-7900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELDON H MEEKS
Credential	:	DC
Telephone Number	:	847-352-4802

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	10/30/2015

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