MEDICARE: DR. SHARON ELLEN WERNER 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022-07202	OTHER	IL	BLUECROSS AND BLUESHIELD

General Provider Information

NPI Number	:	1730271677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON ELLEN WERNER D.C.

Provider Business Mailing Address
First Line	:	117 W ROOSEVELT RD
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3765
Country	:	US
Telephone Number	:	630-876-9191
Fax Number	:	630-876-9192

Provider Business Practice Location Address
First Line	:	117 W ROOSEVELT RD
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3765
Country	:	US
Telephone Number	:	630-876-9191
Fax Number	:	630-876-9192

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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