Provider Demographics
NPI:1114972023
Name:CARA K. HILLWIG, DC, LLC
Entity Type:Organization
Organization Name:CARA K. HILLWIG, DC, LLC
Other - Org Name:QUEEN VILLAGE CHIROPRACTIC & NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR / NUTRITIONIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILLWIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-923-2448
Mailing Address - Street 1:512 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:512 S 4TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1507
Practice Address - Country:US
Practice Address - Phone:215-923-2448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008968111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV00498Medicare UPIN
PA081033SXGMedicare ID - Type UnspecifiedPROVIDER IDENTIFICATION #