Provider Demographics
NPI:1699856120
Name:HUNTER, JUSTIN T (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:T
Last Name:HUNTER
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 1:213 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5312
Mailing Address - Country:US
Mailing Address - Phone:630-435-0100
Mailing Address - Fax:630-435-0110
Practice Address - Street 1:213 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5312
Practice Address - Country:US
Practice Address - Phone:630-435-0100
Practice Address - Fax:630-435-0110
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002232330OtherBLUE CROSS BLUE SHIELD
57-1169616OtherFEDERAL ID
IL206490Medicare ID - Type Unspecified
ILU96383Medicare UPIN