MEDICARE: DR. EL SAYED I OUDA 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
1	111N00000X	Chiropractor		IL

General Provider Information

NPI Number	:	1669645735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EL SAYED I OUDA D C

Provider Business Mailing Address
First Line	:	1244 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2217
Country	:	US
Telephone Number	:	312-697-8887
Fax Number	:	312-697-8889

Provider Business Practice Location Address
First Line	:	1244 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2217
Country	:	US
Telephone Number	:	312-697-8887
Fax Number	:	312-697-8889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/09/2008

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