| Mtb 1, Inc. | |
|
171 N Neltnor Blvd # A, West Chicago, IL 60185-2315 | |
| (630) 231-0777 | |
| (630) 231-0777 |
| Full Name | Mtb 1, Inc. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 171 N Neltnor Blvd # A, West Chicago, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407124621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 038-010351 (Illinois) | Primary |
| Provider Name | Michael Bauer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740296680 PECOS PAC ID: 1951354976 Enrollment ID: I20060419000413 |
| Mailing Address | Practice Location Address |
|---|---|
| Mtb 1, Inc. 956 Park Hill Circle, Aurora, IL 60502-9093 Ph: (630) 585-5283 | Mtb 1, Inc. 171 N Neltnor Blvd # A, West Chicago, IL 60185-2315 Ph: (630) 231-0777 |
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