MEDICARE: H & M MEDICAL, SC

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	038010477	IL

General Provider Information

NPI Number	:	1649582362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H & M MEDICAL, SC

Provider Business Mailing Address
First Line	:	4707 W CERMAK RD
Second Line	:
City	:	CICERO
State	:	IL
Zip	:	60804-2508
Country	:	US
Telephone Number	:	708-780-1280
Fax Number	:	708-780-1237

Provider Business Practice Location Address
First Line	:	3225 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4032
Country	:	US
Telephone Number	:	773-376-0600
Fax Number	:	773-376-0602

Authorized Official
Title or Position	:	SOLE PROPRIETOR/CEO
Name	:	MR. MICHAEL SHOAR
Credential	:	D.C.
Telephone Number	:	805-797-4433

Provider Enumeration Date	:	07/10/2010
Last Update Date	:	07/10/2010

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