Provider Demographics
NPI:1104808401
Name:HASTINGS-KUHLMEIER, ANGELA (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:HASTINGS-KUHLMEIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:HASTINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:507 N STANTON ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61019-7721
Mailing Address - Country:US
Mailing Address - Phone:815-621-5599
Mailing Address - Fax:
Practice Address - Street 1:507 N STANTON ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:IL
Practice Address - Zip Code:61019
Practice Address - Country:US
Practice Address - Phone:815-621-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10132172OtherBCBS
IL038010339Medicaid
IL038010339Medicaid
ILK19734Medicare ID - Type UnspecifiedMEMBER NUMBER