| Dr Gary D Tennant, DC | |
|
386 Forest Blvd, Park Forest, IL 60466-2005 | |
| (708) 481-1715 | |
| (708) 481-8915 |
| Full Name | Dr Gary D Tennant |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 386 Forest Blvd, Park Forest, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780653071 | NPI | - | NPPES |
| 350056091 | Other | IL | RR MEDICARE |
| 1622660 | Other | IL | BCBSIL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 038-005464 (Illinois) | Primary |
| Provider Name | Park Forest Chiropractic, Ltd. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598734295 PECOS PAC ID: 4688764582 Enrollment ID: O20071215000137 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gary D Tennant, DC 386 Forest Blvd, Park Forest, IL 60466-2005 Ph: (708) 481-1715 | Dr Gary D Tennant, DC 386 Forest Blvd, Park Forest, IL 60466-2005 Ph: (708) 481-1715 |
Matthew Thacker, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 437 Springfield St, Park Forest, IL 60466 Phone: 708-870-6161 | |
Park Forest Chiropractic, Ltd. Chiropractor Medicare: Medicare Enrolled Practice Location: 386 Forest Blvd, Park Forest, IL 60466 Phone: 708-481-1715 Fax: 708-481-8915 | |
Dr. David Tyssen, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 386 Forest Blvd, Park Forest, IL 60466 Phone: 708-481-1715 Fax: 708-481-8915 |