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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH LOUISE D.C.

MEDICARE: DR. MICHAEL JOSEPH LOUISE 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
1111N00000XChiropractor038-007067IL

General Provider Information

NPI Number : 1689743767
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH LOUISE D.C.
Provider Business Mailing Address
First Line : 390 E CONGRESS PKWY
Second Line : SUIT
City : CRYSTAL LAKE
State : IL
Zip : 60014-6202
Country : US
Telephone Number : 815-356-5000
Fax Number : 815-356-5003
Provider Business Practice Location Address
First Line : 390 E CONGRESS PKWY
Second Line : SUITE F
City : CRYSTAL LAKE
State : IL
Zip : 60014-6202
Country : US
Telephone Number : 815-356-5000
Fax Number : 815-356-5003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 10/30/2015

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