Provider Demographics
NPI:1790874568
Name:FRANKLIN, MICHELLE L (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240-9308
Mailing Address - Country:US
Mailing Address - Phone:309-799-7422
Mailing Address - Fax:309-799-7401
Practice Address - Street 1:102 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:COAL VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61240-9308
Practice Address - Country:US
Practice Address - Phone:309-799-7422
Practice Address - Fax:309-799-7401
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009164111N00000X
IA06313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038009164Medicaid
IL038009164Medicaid
ILU81561Medicare UPIN