MEDICARE: MICHAEL J LOUISE, DC, LTD

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	038007067	IL

General Provider Information

NPI Number	:	1821391749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL J LOUISE, DC, LTD

Provider Business Mailing Address
First Line	:	22 N SALEM AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 N SALEM AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1435
Country	:	US
Telephone Number	:	847-274-9530
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MICHAEL JOSEPH LOUISE
Credential	:	DC
Telephone Number	:	847-274-9530

Provider Enumeration Date	:	12/15/2010
Last Update Date	:	12/15/2010

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