MEDICARE: ASHLEY FRER 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	038-009436	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1627873	OTHER	IL	BCBSIL

General Provider Information

NPI Number	:	1871562793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY FRER D.C.

Provider Business Mailing Address
First Line	:	3221 N SHEFFIELD AVE
Second Line	:	# C-1S
City	:	CHICAGO
State	:	IL
Zip	:	60657-8510
Country	:	US
Telephone Number	:	773-325-9010
Fax Number	:	773-404-5172

Provider Business Practice Location Address
First Line	:	3221 N SHEFFIELD AVE
Second Line	:	# C-1S
City	:	CHICAGO
State	:	IL
Zip	:	60657-8510
Country	:	US
Telephone Number	:	773-325-9010
Fax Number	:	773-404-5172

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	12/29/2009

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Directions to “ ASHLEY FRER D.C.” Practice Location

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