Provider Demographics
NPI:1073538377
Name:SCHLICK, AMANDA JILL (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JILL
Last Name:SCHLICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-1542
Mailing Address - Country:US
Mailing Address - Phone:618-392-2223
Mailing Address - Fax:618-392-3261
Practice Address - Street 1:600 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-1542
Practice Address - Country:US
Practice Address - Phone:618-392-2223
Practice Address - Fax:618-392-3261
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038010320Medicaid
IL08032008OtherBLUE CROSS BLUE SHIELD
IL701274OtherHEALTHLINK
IL5638354OtherFIRST HEALTH NETWORK
ILV04311Medicare UPIN
IL701274OtherHEALTHLINK