Provider Demographics
NPI:1629585682
Name:LANHUM CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:LANHUM CHIROPRACTIC, INC
Other - Org Name:LANHUM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:P
Authorized Official - Last Name:LANHUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-430-4697
Mailing Address - Street 1:200 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62363-1954
Mailing Address - Country:US
Mailing Address - Phone:217-285-6300
Mailing Address - Fax:
Practice Address - Street 1:200 S MADISON ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363
Practice Address - Country:US
Practice Address - Phone:217-285-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03812644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038-012644OtherSTATE LICENSE