Provider Demographics
NPI:1841385945
Name:HOVI CLINIC OF CHIROPRACTIC, PC
Entity type:Organization
Organization Name:HOVI CLINIC OF CHIROPRACTIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HOVI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-338-9150
Mailing Address - Street 1:1400 N SEMINARY AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2980
Mailing Address - Country:US
Mailing Address - Phone:815-338-9150
Mailing Address - Fax:815-337-0279
Practice Address - Street 1:1400 N SEMINARY AVE
Practice Address - Street 2:STE K
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-2980
Practice Address - Country:US
Practice Address - Phone:815-338-9150
Practice Address - Fax:815-337-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370720Medicare PIN