Provider Demographics
NPI:1326296179
Name:DR ADAM FINK FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DR ADAM FINK FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:P
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-854-3300
Mailing Address - Street 1:110 E 1ST NORTH ST
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-1505
Mailing Address - Country:US
Mailing Address - Phone:217-854-3300
Mailing Address - Fax:
Practice Address - Street 1:1060 HIGHWAY 15 S
Practice Address - Street 2:HUTCHINSON MALL
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3157
Practice Address - Country:US
Practice Address - Phone:320-234-3584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN98N95FIOtherBLUE CROSS BLUE SHIELD OF MN NON PARTICIPATING GROUP ID
MNC05054OtherMEDICARE GROUP PTAN