MEDICARE: WALTER ANTHONY KARBOWSKI DC

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	038007471	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	038007471	OTHER	IL	BCBS PROVIDER #

General Provider Information

NPI Number	:	1558473587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER ANTHONY KARBOWSKI DC

Provider Business Mailing Address
First Line	:	4701 N CUMBERLAND AVE
Second Line	:	# 13-14
City	:	NORRIDGE
State	:	IL
Zip	:	60706-2905
Country	:	US
Telephone Number	:	708-452-4444
Fax Number	:	708-452-7090

Provider Business Practice Location Address
First Line	:	4701 N CUMBERLAND AVE
Second Line	:	# 13-14
City	:	NORRIDGE
State	:	IL
Zip	:	60706-2905
Country	:	US
Telephone Number	:	708-452-4444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	09/29/2017

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