MEDICARE: LYNN M FLORIAN 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	:	1679528517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN M FLORIAN D.C.

Provider Business Mailing Address
First Line	:	557 GREENLEAF AVE
Second Line	:
City	:	PARK CITY
State	:	IL
Zip	:	60085-5728
Country	:	US
Telephone Number	:	847-623-1122
Fax Number	:	847-623-1840

Provider Business Practice Location Address
First Line	:	557 GREENLEAF AVE
Second Line	:
City	:	PARK CITY
State	:	IL
Zip	:	60085-5728
Country	:	US
Telephone Number	:	847-623-1122
Fax Number	:	847-623-1840

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	07/08/2007

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