Provider Demographics
NPI:1114287877
Name:HERSHBERGER, AMY R (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:R
Last Name:HERSHBERGER
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 1:506 N ELIDA ST
Mailing Address - Street 2:PO BOX 383
Mailing Address - City:WINNEBAGO
Mailing Address - State:IL
Mailing Address - Zip Code:61088
Mailing Address - Country:US
Mailing Address - Phone:815-335-1381
Mailing Address - Fax:
Practice Address - Street 1:506 N ELIDA ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WINNEBAGO
Practice Address - State:IL
Practice Address - Zip Code:61088
Practice Address - Country:US
Practice Address - Phone:815-541-7719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor