MEDICARE: NATURAL CARE CHIROPRACTIC PC

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	038-007946	IL

General Provider Information

NPI Number	:	1780950469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL CARE CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	2118 E. GRAND AVE
Second Line	:
City	:	LINDENHURST
State	:	IL
Zip	:	60046-9030
Country	:	US
Telephone Number	:	847-265-0600
Fax Number	:	847-265-0620

Provider Business Practice Location Address
First Line	:	2118 E GRAND AVE
Second Line	:
City	:	LINDENHURST
State	:	IL
Zip	:	60046-9030
Country	:	US
Telephone Number	:	847-265-0600
Fax Number	:	847-265-0620

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK J FREUND
Credential	:	DC
Telephone Number	:	847-456-0881

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	03/28/2012

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