MEDICARE: NORTHCENTER HEALTHCARE INC

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

General Provider Information

NPI Number	:	1962796516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHCENTER HEALTHCARE INC

Provider Business Mailing Address
First Line	:	4045 N DAMEN AVE
Second Line	:	#1
City	:	CHICAGO
State	:	IL
Zip	:	60618-3148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4045 N DAMEN AVE
Second Line	:	#1
City	:	CHICAGO
State	:	IL
Zip	:	60618-3148
Country	:	US
Telephone Number	:	773-296-2766
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALISHA SCHAFER
Credential	:
Telephone Number	:	773-296-2766

Provider Enumeration Date	:	05/31/2011
Last Update Date	:	06/14/2011

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Directions to “NORTHCENTER HEALTHCARE INC ” Practice Location

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