Provider Demographics
NPI:1922136365
Name:HUNTER FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HUNTER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-435-0100
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002232330OtherBLUE CROSS BLUE SHIELD
ILU96383Medicare UPIN