Provider Demographics
NPI:1295705796
Name:OCHSNER, ASHLY LYNN
Entity type:Individual
Prefix:
First Name:ASHLY
Middle Name:LYNN
Last Name:OCHSNER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ASHLY
Other - Middle Name:LYNN
Other - Last Name:OCHSNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:11124 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1525
Mailing Address - Country:US
Mailing Address - Phone:708-478-9850
Mailing Address - Fax:708-942-8334
Practice Address - Street 1:11124 FRONT ST
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1525
Practice Address - Country:US
Practice Address - Phone:708-478-9850
Practice Address - Fax:708-349-0060
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008680111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213126OtherMEDICARE PTAN
IL10125693OtherBCBS
IL213126OtherMEDICARE PTAN
IL610700Medicare ID - Type Unspecified