Provider Demographics
NPI:1679647804
Name:HACKEL, CHAD ERIN (DC)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:ERIN
Last Name:HACKEL
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 1:606 SOUTH 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-2408
Mailing Address - Country:US
Mailing Address - Phone:308-872-2171
Mailing Address - Fax:308-872-6093
Practice Address - Street 1:606 SOUTH 9TH AVE
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-2408
Practice Address - Country:US
Practice Address - Phone:308-872-2171
Practice Address - Fax:308-872-6093
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE33103551700Medicaid
NE99599OtherBCBS
239266OtherMIDLANDS CHOICE
NE33103551700Medicaid
239266OtherMIDLANDS CHOICE