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NPI Code Detail

MEDICARE: CHRISTOPHER WORTH DC

MEDICARE:   CHRISTOPHER  WORTH  DC
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811945058
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER WORTH DC
Provider Business Mailing Address
First Line : 5007 N ILLINOIS ST
Second Line : SUITE 1
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-3419
Country : US
Telephone Number : 618-235-4357
Fax Number : 618-235-9865
Provider Business Practice Location Address
First Line : 5007 N ILLINOIS ST
Second Line : SUITE 1
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-3419
Country : US
Telephone Number : 618-235-4357
Fax Number : 618-235-9865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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Directions to “ CHRISTOPHER WORTH DC” Practice Location

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