MEDICARE: DR. CHRISTOPHER AVILA DCAM

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	171100000X	Acupuncturist	198001676	IL
2	225700000X	Massage Therapist	227.014192	IL

General Provider Information

NPI Number	:	1801645130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER AVILA DCAM

Provider Business Mailing Address
First Line	:	3526 N BOSWORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1364
Country	:	US
Telephone Number	:	312-478-8779
Fax Number	:

Provider Business Practice Location Address
First Line	:	1564 N DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2100
Country	:	US
Telephone Number	:	312-478-8779
Fax Number	:

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

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	09/04/2025

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Directions to “ DR. CHRISTOPHER AVILA DCAM” Practice Location

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