MEDICARE: HERWIG 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	038007374	IL

General Provider Information

NPI Number	:	1548363088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERWIG CHIROPRACTIC LTD

Provider Business Mailing Address
First Line	:	712 N BLOOMINGTON ST
Second Line	:
City	:	STREATOR
State	:	IL
Zip	:	61364-2087
Country	:	US
Telephone Number	:	815-672-6961
Fax Number	:	815-672-6891

Provider Business Practice Location Address
First Line	:	712 N BLOOMINGTON ST
Second Line	:
City	:	STREATOR
State	:	IL
Zip	:	61364-2087
Country	:	US
Telephone Number	:	815-672-6961
Fax Number	:	815-672-6891

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM CURTIS HERWIG
Credential	:	DC
Telephone Number	:	630-208-9332

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	12/07/2015

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