Provider Demographics
NPI:1073652913
Name:ADAMS, GAY LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:GAY
Middle Name:LYNNE
Last Name:ADAMS
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:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IL
Mailing Address - Zip Code:61856-0235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1109 N STATE ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IL
Practice Address - Zip Code:61856-1175
Practice Address - Country:US
Practice Address - Phone:217-762-8576
Practice Address - Fax:217-762-8578
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL07423137OtherBLUE SHIELD
IL350049146OtherRAILROAD MEDICARE
IL350049146OtherRAILROAD MEDICARE
IL533710Medicare ID - Type Unspecified