Provider Demographics
NPI:1487701231
Name:FILIPIAK, JAMES ALLEN (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:FILIPIAK
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 1:316 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-2017
Mailing Address - Country:US
Mailing Address - Phone:217-234-2225
Mailing Address - Fax:
Practice Address - Street 1:2112 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-2741
Practice Address - Country:US
Practice Address - Phone:217-234-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL182402OtherPERSONAL CARE
IL016225564OtherBLUE CROSS BLUE SHIELD
IL016225564OtherBLUE CROSS BLUE SHIELD