Provider Demographics
NPI:1154482958
Name:MCCABE, EMILY (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 VILLAGE OFFICE PL
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-7673
Mailing Address - Country:US
Mailing Address - Phone:217-355-1798
Mailing Address - Fax:217-352-9105
Practice Address - Street 1:3105 VILLAGE OFFICE PL
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-7673
Practice Address - Country:US
Practice Address - Phone:217-355-1798
Practice Address - Fax:217-352-9105
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor