MEDICARE: ARLINGTON NORTH CHIROPRACTIC CENTER P.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
1	111N00000X	Chiropractor		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01617501	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1609090992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON NORTH CHIROPRACTIC CENTER P.C.

Provider Business Mailing Address
First Line	:	149 W RAND RD
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 W RAND RD
Second Line	:
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:	847-870-7980
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH VISTITSKY
Credential	:	D.C.
Telephone Number	:	847-870-7980

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/21/2022

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