Provider Demographics
NPI:1891995502
Name:MCCLURE CHIROPRACTIC AND ACUPUNCTURE, P.C.
Entity Type:Organization
Organization Name:MCCLURE CHIROPRACTIC AND ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-837-3090
Mailing Address - Street 1:111 W RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4498
Mailing Address - Country:US
Mailing Address - Phone:630-837-3090
Mailing Address - Fax:630-837-3053
Practice Address - Street 1:111 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4498
Practice Address - Country:US
Practice Address - Phone:630-837-3090
Practice Address - Fax:630-837-3053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038007476Medicaid
ILU51578Medicare UPIN
IL038007476Medicaid
210316Medicare Oscar/Certification