MEDICARE: DEBORAH L WEISS-DEBROWN PC

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	038007346	IL
2	111N00000X	Chiropractor	038004214	IL

General Provider Information

NPI Number	:	1871793810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBORAH L WEISS-DEBROWN PC

Provider Business Mailing Address
First Line	:	6416 W HIGGINS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60656-2203
Country	:	US
Telephone Number	:	773-774-6771
Fax Number	:	773-774-6789

Provider Business Practice Location Address
First Line	:	6416 W HIGGINS AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60656-2203
Country	:	US
Telephone Number	:	773-774-6771
Fax Number	:	773-774-6789

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DEBORAH L WEISS-DEBROWN
Credential	:	DC
Telephone Number	:	773-774-6771

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	02/01/2010

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