Provider Demographics
NPI:1316911852
Name:BABCOCK, TODD H (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:H
Last Name:BABCOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:IL
Mailing Address - Zip Code:62640-1608
Mailing Address - Country:US
Mailing Address - Phone:217-627-4144
Mailing Address - Fax:217-627-4139
Practice Address - Street 1:115 S 2ND ST
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:IL
Practice Address - Zip Code:62640-1608
Practice Address - Country:US
Practice Address - Phone:217-627-4144
Practice Address - Fax:217-627-4139
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05480111N00000X
IL038-006470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE243963OtherMIDLAND CHOICE
CT007527001OtherAETNA