MEDICARE: BRIAN LEE TUTOR DC

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	038004980	IL

General Provider Information

NPI Number	:	1699883421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN LEE TUTOR DC

Provider Business Mailing Address
First Line	:	961 OAK ST
Second Line	:
City	:	NORTH AURORA
State	:	IL
Zip	:	60542-1579
Country	:	US
Telephone Number	:	630-896-5170
Fax Number	:	630-896-5176

Provider Business Practice Location Address
First Line	:	961 OAK ST
Second Line	:
City	:	NORTH AURORA
State	:	IL
Zip	:	60542-1579
Country	:	US
Telephone Number	:	630-896-5170
Fax Number	:	630-896-5176

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/10/2014

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Directions to “ BRIAN LEE TUTOR DC” Practice Location

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