MEDICARE: DR. RAYMOND SALVATORE MANASIA 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	038007565	IL

General Provider Information

NPI Number	:	1861401044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND SALVATORE MANASIA D.C.

Provider Business Mailing Address
First Line	:	211 N CLINTON ST
Second Line	:	SUITE 2S
City	:	CHICAGO
State	:	IL
Zip	:	60661-1282
Country	:	US
Telephone Number	:	312-262-7969
Fax Number	:	708-221-7108

Provider Business Practice Location Address
First Line	:	211 N CLINTON ST
Second Line	:	SUITE 2S
City	:	CHICAGO
State	:	IL
Zip	:	60661-1282
Country	:	US
Telephone Number	:	312-262-7969
Fax Number	:	708-221-7108

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	03/29/2017

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