Provider Demographics
NPI:1518967298
Name:HILLENBRAND, RAYMOND JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JAMES
Last Name:HILLENBRAND
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 1:2105 E HONEYSUCKLE PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2318
Mailing Address - Country:US
Mailing Address - Phone:480-284-9072
Mailing Address - Fax:480-945-6201
Practice Address - Street 1:7620 E INDIAN SCHOOL RD STE 114
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3610
Practice Address - Country:US
Practice Address - Phone:480-284-9072
Practice Address - Fax:480-945-6201
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3629111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F329590OtherBCBSM
MI290652114Medicaid
0005246438OtherAETNA
MI950F329590OtherBCBSM
MI290652114Medicaid