Provider Demographics
NPI:1275655060
Name:HUGGINS CHIROPRACTIC AND ACUPUNCTURECLINICLTD
Entity Type:Organization
Organization Name:HUGGINS CHIROPRACTIC AND ACUPUNCTURECLINICLTD
Other - Org Name:HUGGINS INTEGRATIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARYLLON
Authorized Official - Middle Name:CUMMINGS
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DACBN,CCN,CCSP,
Authorized Official - Phone:847-482-1000
Mailing Address - Street 1:25 GREEN BAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2301
Mailing Address - Country:US
Mailing Address - Phone:847-482-1000
Mailing Address - Fax:
Practice Address - Street 1:25 GREEN BAY RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2301
Practice Address - Country:US
Practice Address - Phone:847-482-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38007518111N00000X, 111NN1001X, 111NS0005X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4921996OtherBC BS
IL433072Medicare ID - Type Unspecified
IL4921996OtherBC BS