MEDICARE: ALEX CHRISTIAN GUEBERT 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	038.012936	IL

General Provider Information

NPI Number	:	1730546995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX CHRISTIAN GUEBERT D.C.

Provider Business Mailing Address
First Line	:	10513 LINCOLN TRL
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1911
Country	:	US
Telephone Number	:	618-398-7550
Fax Number	:

Provider Business Practice Location Address
First Line	:	10513 LINCOLN TRL
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1911
Country	:	US
Telephone Number	:	618-398-7550
Fax Number	:

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

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	01/19/2016

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