MEDICARE: O'HARA FAMILY CHIROPRACTIC, 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	111N00000X	Chiropractor	038011088	IL

General Provider Information

NPI Number	:	1528399326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'HARA FAMILY CHIROPRACTIC, LTD

Provider Business Mailing Address
First Line	:	940 S ARTHUR AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2829
Country	:	US
Telephone Number	:	847-577-3597
Fax Number	:	847-577-5168

Provider Business Practice Location Address
First Line	:	940 S ARTHUR AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2829
Country	:	US
Telephone Number	:	847-577-3795
Fax Number	:	847-577-5168

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DR. KEVIN TIMOTHY O'HARA
Credential	:	D.C.
Telephone Number	:	847-577-3597

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	10/19/2010

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