Provider Demographics
NPI:1306858154
Name:NATURAL FAMILY HEALTH S.C.
Entity Type:Organization
Organization Name:NATURAL FAMILY HEALTH S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MOEGLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-784-4554
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60145-0240
Mailing Address - Country:US
Mailing Address - Phone:815-784-4554
Mailing Address - Fax:
Practice Address - Street 1:112 N EMMETT ST STE A
Practice Address - Street 2:
Practice Address - City:GENOA
Practice Address - State:IL
Practice Address - Zip Code:60135-1087
Practice Address - Country:US
Practice Address - Phone:815-784-4554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
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
ILU82999Medicare UPIN
ILK17570Medicare ID - Type Unspecified