Provider Demographics
NPI:1396751897
Name:HUNT, BLAIR D (DC)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:D
Last Name:HUNT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4410 N KNOXVILLE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-6086
Mailing Address - Country:US
Mailing Address - Phone:309-282-6419
Mailing Address - Fax:309-282-6003
Practice Address - Street 1:4410 N KNOXVILLE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-6086
Practice Address - Country:US
Practice Address - Phone:309-282-6419
Practice Address - Fax:309-282-6003
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1912088OtherFIRST HEALTH NETWORK
IL7927178OtherAETNA
IL6733216OtherACN
IL7232127OtherBLUE CROSS/ BLUE SHIELD
IL7232127OtherBLUE CROSS/ BLUE SHIELD
IL1912088OtherFIRST HEALTH NETWORK