MEDICARE: K & E MEDICAL 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	207R00000X	Internal Medicine Physician	036056245	IL
2	111N00000X	Chiropractor	042006313	IL

General Provider Information

NPI Number	:	1609900489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K & E MEDICAL LTD.

Provider Business Mailing Address
First Line	:	600 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3531
Country	:	US
Telephone Number	:	312-243-3411
Fax Number	:	312-733-8381

Provider Business Practice Location Address
First Line	:	600 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3531
Country	:	US
Telephone Number	:	312-243-3411
Fax Number	:	312-733-8381

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELLIOTT MATTHEW CHAY
Credential	:	D.C.
Telephone Number	:	312-243-3411

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	02/01/2012

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