MEDICARE: ING CHIROPRACTIC AND ACUPUNCTURE, LTD

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	261QH0100X	Health Service Clinic/Center	038003416	IL

General Provider Information

NPI Number	:	1700231479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ING CHIROPRACTIC AND ACUPUNCTURE, LTD

Provider Business Mailing Address
First Line	:	12309 S HARLEM AVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1444
Country	:	US
Telephone Number	:	708-448-7772
Fax Number	:	708-448-4470

Provider Business Practice Location Address
First Line	:	12309 S HARLEM AVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1444
Country	:	US
Telephone Number	:	708-448-7772
Fax Number	:	708-448-4470

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WALLACE ING
Credential	:	D.C.
Telephone Number	:	708-448-7772

Provider Enumeration Date	:	04/29/2016
Last Update Date	:	05/05/2016

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