MEDICARE: DR. SCOTT R FLADLAND 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	038-005644	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01682740	OTHER	IL	BCBSIL

General Provider Information

NPI Number	:	1922077874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT R FLADLAND D.C.

Provider Business Mailing Address
First Line	:	17 N WABASH AVE
Second Line	:	SUITE 500
City	:	CHICAGO
State	:	IL
Zip	:	60602-4717
Country	:	US
Telephone Number	:	312-346-7313
Fax Number	:	312-346-6530

Provider Business Practice Location Address
First Line	:	17 N WABASH AVE
Second Line	:	SUITE 500
City	:	CHICAGO
State	:	IL
Zip	:	60602-4717
Country	:	US
Telephone Number	:	312-346-7313
Fax Number	:	312-346-6530

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	06/18/2008

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Directions to “ DR. SCOTT R FLADLAND D.C.” Practice Location

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