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NPI Code Detail

MEDICARE: NORTH SHORE SPINE & WELLNESS INC

MEDICARE: NORTH SHORE SPINE & WELLNESS 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
1111N00000XChiropractor038012411IL

General Provider Information

NPI Number : 1528405545
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH SHORE SPINE & WELLNESS INC
Provider Business Mailing Address
First Line : 5833 DEMPSTER ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-3028
Country : US
Telephone Number : 847-966-1955
Fax Number :
Provider Business Practice Location Address
First Line : 5833 DEMPSTER ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-3028
Country : US
Telephone Number : 847-966-1955
Fax Number :
Authorized Official
Title or Position : CHIROPRACTIC PHYSICIAN
Name : DR. ADI SWEILEM
Credential : D.C.
Telephone Number : 847-966-1955
Provider Enumeration Date : 05/30/2013
Last Update Date : 08/20/2014

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Directions to “NORTH SHORE SPINE & WELLNESS INC ” Practice Location

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