Provider Demographics
NPI:1013012673
Name:GILL, CHAD S (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:S
Last Name:GILL
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 1:1021 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-2812
Mailing Address - Country:US
Mailing Address - Phone:620-399-9355
Mailing Address - Fax:620-399-8917
Practice Address - Street 1:1021 E 16TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-2812
Practice Address - Country:US
Practice Address - Phone:620-399-9355
Practice Address - Fax:620-399-8917
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU88467Medicare UPIN
KS660100Medicare ID - Type UnspecifiedGROUP
KS062170Medicare ID - Type UnspecifiedINDIVIDUAL