MEDICARE: DR. ELLIOTT MATTHEW CHAY

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	111NR0400X	Rehabilitation Chiropractor	038008992	IL

General Provider Information

NPI Number	:	1972875268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLIOTT MATTHEW CHAY

Provider Business Mailing Address
First Line	:	600 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3531
Country	:	US
Telephone Number	:	312-243-3411
Fax Number	:	312-733-8381

Provider Business Practice Location Address
First Line	:	600 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3531
Country	:	US
Telephone Number	:	312-243-3411
Fax Number	:	312-733-8381

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

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	02/01/2012

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