Mount Vernon Chiropractic Clinic
LBN: Mount Vernon Chiropractic Clinic
Mount Vernon Chiropractic Clinic is an health care organization with primary practice located at 1315 Main St , Mount Vernon IL 62864-3720. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty.
Mount Vernon Chiropractic Clinic can be contacted via phone (618) 242-4554, or through Drake, Bradley Ray via phone (618) 242-4554.
Contact Information
Primary practice address
1315 Main St
Mount Vernon IL 62864-3720
Phone: (618) 242-4554
Fax: (618) 242-4653
Website:
Authorized official contact:
Name: Drake, Bradley Ray Doctor of Chiropractic (DC)
Phone: (618) 242-4554
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | 038006100 | Illinois |
Profile Details
| NPI number | 1881888105 |
|---|---|
| LBN Legal business name | Mount Vernon Chiropractic Clinic |
| DBA Doing business as | |
| Authorized official | Drake, Bradley Ray Doctor of Chiropractic (DC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 29th, 2007 |
| Last updated | Aug 29th, 2007 - about 19 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881888105 | NPPES |
| Illinois | Other | 4182010 | BLUE CROSS BLUE SHIELD |
| Illinois | MEDICAID | 038006100 | BLUE CROSS BLUE SHIELD |
| Illinois | Other | 350027546 | BLUE CROSS BLUE SHIELD |
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