MEDICARE: COMPASSIONATE CHIROPRACTIC CARE, LLC

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

General Provider Information

NPI Number	:	1811757909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CHIROPRACTIC CARE, LLC

Provider Business Mailing Address
First Line	:	21 BERGMAN CT APT 7
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1258
Country	:	US
Telephone Number	:	773-414-8836
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 BERGMAN CT APT 7
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1258
Country	:	US
Telephone Number	:	773-414-8836
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SOPHIA E. DABNEY
Credential	:	DC
Telephone Number	:	773-414-8836

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/19/2024

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