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Contact Information

AXIS MEDICAL MANAGEMENT GOUP SC
4111 W 26TH ST
SUITE 110
CHICAGO, IL60623-4313
 Phone: 773-542-1111
 Fax: 773-542-7100
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

111NR0400X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for AXIS MEDICAL MANAGEMENT GOUP SC · (Female)

NPI Number 1932221397
Status Active
Credentials
Entity Individual
Enumeration date 04/05/2007
Last updated 04/25/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 042.618397038.010225
  • IL Other 1634898 BLUE CROSS BLUE SHIELD ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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