Provider Demographics
NPI:1205826302
Name:SCHIPPEL CHIROPRACTIC SC
Entity Type:Organization
Organization Name:SCHIPPEL CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-245-9797
Mailing Address - Street 1:1429 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650
Mailing Address - Country:US
Mailing Address - Phone:217-245-9797
Mailing Address - Fax:217-245-2524
Practice Address - Street 1:1429 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650
Practice Address - Country:US
Practice Address - Phone:217-245-9797
Practice Address - Fax:217-245-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06922750OtherBLUE CROSS BLUE SHIELD
IL1194855OtherFIRST HEALTH
IL391375OtherHEALTHLINK
IL045216OtherHEALTH ALLIANCE
IL045216OtherHEALTH ALLIANCE
IL1194855OtherFIRST HEALTH