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Organization

MARTIN J. LABUDA, DC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTIN JOHN LABUDA JR. DC (PRESIDENT)
(773) 296-2225
Entity
Organization

Contact information

Practice address
3832 N BROADWAY ST, CHICAGO, IL 60613-3218
(773) 296-2225
(773) 296-0731
Mailing address
3832 N BROADWAY ST, CHICAGO, IL 60613-3218
(773) 296-2225
(773) 296-0731

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009597
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01632439
BLUE CROSS BLUE SHIELD
IL
01
4063763
CIGNA
IL
01
IL7546
MEDICARE PTAN
IL
Enumeration date
06/01/2007
Last updated
07/13/2016
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