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NPI Code Detail

MEDICARE: DR. IRMINA TREBERT D.C.

MEDICARE: DR. IRMINA TREBERT 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
11683003OTHERILB.C.B.S.

General Provider Information

NPI Number : 1649357674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRMINA TREBERT D.C.
Provider Business Mailing Address
First Line : 7122 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1904
Country : US
Telephone Number : 773-844-4577
Fax Number :
Provider Business Practice Location Address
First Line : 7122 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1904
Country : US
Telephone Number : 773-844-4577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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