MEDICARE: DR. TODD CHRISTIAN RENN 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	038009174	IL

General Provider Information

NPI Number	:	1790839926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD CHRISTIAN RENN D.C.

Provider Business Mailing Address
First Line	:	5808 N SAINT LOUIS AVE
Second Line	:	APT 1
City	:	CHICAGO
State	:	IL
Zip	:	60659-4408
Country	:	US
Telephone Number	:	773-267-9442
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 N RAVENSWOOD AVE
Second Line	:	SUITE 105
City	:	CHICAGO
State	:	IL
Zip	:	60640-1668
Country	:	US
Telephone Number	:	773-878-7330
Fax Number	:

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/19/2018

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