Provider Demographics
NPI:1518080399
Name:HILO, JOHN JACQUES (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JACQUES
Last Name:HILO
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 1:158 WATER ST. N.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057
Mailing Address - Country:US
Mailing Address - Phone:651-270-1414
Mailing Address - Fax:507-663-0276
Practice Address - Street 1:158 WATER ST. N.
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057
Practice Address - Country:US
Practice Address - Phone:651-270-1414
Practice Address - Fax:507-663-0276
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN89G96HIOtherBLUE CROSS BLUE SHEILD
MN89G96HIOtherBLUE CROSS BLUE SHEILD