Provider Demographics
NPI:1013191956
Name:HUGHES, TODD J (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:HUGHES
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 1:2025 W ILES AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4190
Mailing Address - Country:US
Mailing Address - Phone:217-787-7500
Mailing Address - Fax:
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:62704-4190
Practice Address - Country:US
Practice Address - Phone:217-787-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-006369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204467Medicare PIN