Provider Demographics
NPI:1215190020
Name:ATKINS, DAVID M (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:ATKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-3583
Mailing Address - Country:US
Mailing Address - Phone:217-243-5700
Mailing Address - Fax:217-243-5711
Practice Address - Street 1:1853 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-3583
Practice Address - Country:US
Practice Address - Phone:217-243-5700
Practice Address - Fax:217-243-5711
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010778111N00000X, 111NN1001X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor