Provider Demographics
NPI:1861026122
Name:VANPELT, LUCAS AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:AARON
Last Name:VANPELT
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 1:670 W GORHAM RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62940-2420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 N SPARTA ST
Practice Address - Street 2:
Practice Address - City:STEELEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62288-1541
Practice Address - Country:US
Practice Address - Phone:618-965-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor