MEDICARE: A BETTER WEIGH, INC

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	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1689989717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A BETTER WEIGH, INC

Provider Business Mailing Address
First Line	:	1931 W 95TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1105
Country	:	US
Telephone Number	:	773-496-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 W 95TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1105
Country	:	US
Telephone Number	:	773-496-4222
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CHANAY A WALTON
Credential	:
Telephone Number	:	773-496-4222

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	08/12/2010

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Directions to “A BETTER WEIGH, INC ” Practice Location

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