MEDICARE: MARQUE MEDICOS 26TH STREET, 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	038008088	IL

General Provider Information

NPI Number	:	1528204088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARQUE MEDICOS 26TH STREET, LLC.

Provider Business Mailing Address
First Line	:	4176 W MONTROSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2161
Country	:	US
Telephone Number	:	773-283-3131
Fax Number	:	773-283-3610

Provider Business Practice Location Address
First Line	:	3501 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3910
Country	:	US
Telephone Number	:	773-283-3131
Fax Number	:	773-283-3610

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. DERRICK D. WALLERY
Credential	:	D.C.
Telephone Number	:	773-283-3131

Provider Enumeration Date	:	01/05/2009
Last Update Date	:	01/05/2009

Similar Medicare Providers

1760438477 — FERNANDO A AMPUERO MD
Practice Location Address:

3517 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-521-6001
Practice Fax: 773-521-1154

1679680235 — LAWNDALE CHRISTIAN HEALTH CENTER
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3256
Practice Fax: 872-588-3251

1336363563 — CLINICA GUADALUPE PC
Practice Location Address:

3511 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-277-9100
Practice Fax: 773-277-0860

1114389400 — APRIL BOWGREN BCBA
Practice Location Address:

3501 W 26TH ST
CHICAGO, IL
60623-3910

Practice Phone: 773-372-2492
Practice Fax:

1992339949 — DR. RAYYA AJEENAH HUNTER PHARMD
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3250
Practice Fax:

1669066023 — MADELINE M MEISTER
Practice Location Address:

3910 W OGDEN AVE
CHICAGO, IL
60623-2470

Practice Phone: 872-588-3250
Practice Fax:

Directions to “MARQUE MEDICOS 26TH STREET, LLC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.