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NPI Code Detail

MEDICARE: DR. SARAH ELIZABETH NICOLI THURSBY D.C.

MEDICARE:  DR. SARAH ELIZABETH NICOLI THURSBY  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
1111N00000XChiropractor38010796IL

General Provider Information

NPI Number : 1639263379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH ELIZABETH NICOLI THURSBY D.C.
Provider Business Mailing Address
First Line : 2318 W POLK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4242
Country : US
Telephone Number : 312-802-5375
Fax Number :
Provider Business Practice Location Address
First Line : 2318 W POLK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4242
Country : US
Telephone Number : 312-802-5375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SARAH ELIZABETH NICOLI THURSBY D.C.” Practice Location

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