Provider Demographics
NPI:1285632620
Name:ARN, ALECIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALECIA
Middle Name:
Last Name:ARN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N HILL RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2154
Mailing Address - Country:US
Mailing Address - Phone:815-389-7911
Mailing Address - Fax:
Practice Address - Street 1:13019 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-8248
Practice Address - Country:US
Practice Address - Phone:815-389-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10125948OtherBCBS OF ILLINOIS
IL10125948OtherBCBS OF ILLINOIS
ILU79403Medicare UPIN