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NPI Code Detail

MEDICARE: BOTTI CHIROPRACTIC & WELLNESS INC.

MEDICARE: BOTTI CHIROPRACTIC & WELLNESS INC.
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
1111N00000XChiropractor038.011600IL

General Provider Information

NPI Number : 1780953026
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOTTI CHIROPRACTIC & WELLNESS INC.
Provider Business Mailing Address
First Line : 5569 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2356
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5569 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2356
Country : US
Telephone Number : 708-717-5947
Fax Number :
Authorized Official
Title or Position : CHIROPRACTIC PHYSICIAN
Name : DR. VALENTINO BOTTI
Credential : D.C.
Telephone Number : 708-717-5947
Provider Enumeration Date : 12/15/2011
Last Update Date : 12/15/2011

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