Provider Demographics
NPI:1528165743
Name:HUGHES CHIROPRACTIC HEALTHCARE SC
Entity type:Organization
Organization Name:HUGHES CHIROPRACTIC HEALTHCARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-787-7500
Mailing Address - Street 1:2025 W ILES AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4197
Mailing Address - Country:US
Mailing Address - Phone:217-787-7500
Mailing Address - Fax:217-787-8479
Practice Address - Street 1:2025 W ILES AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-4197
Practice Address - Country:US
Practice Address - Phone:217-787-7500
Practice Address - Fax:217-787-8479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T90437Medicare UPIN
204467Medicare PIN