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NPI Code Detail

MEDICARE: DR. JOHN BRYAN TAYLOR D.C.

MEDICARE: DR. JOHN BRYAN TAYLOR D.C.
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18426897OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1578572665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN BRYAN TAYLOR D.C.
Provider Business Mailing Address
First Line : 101 E PLUMMER BLVD
Second Line :
City : CHATHAM
State : IL
Zip : 62629-8047
Country : US
Telephone Number : 217-483-1551
Fax Number : 217-483-6294
Provider Business Practice Location Address
First Line : 101 E PLUMMER BLVD
Second Line :
City : CHATHAM
State : IL
Zip : 62629-8047
Country : US
Telephone Number : 217-483-1551
Fax Number : 217-483-6294
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN BRYAN TAYLOR D.C.” Practice Location

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