Provider Demographics
NPI:1932156486
Name:MUNHOFEN, NEIL ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ANDREW
Last Name:MUNHOFEN
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 1:414A BELTLINE RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4405
Mailing Address - Country:US
Mailing Address - Phone:618-343-1100
Mailing Address - Fax:618-343-0546
Practice Address - Street 1:414A BELTLINE RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4405
Practice Address - Country:US
Practice Address - Phone:618-343-1100
Practice Address - Fax:618-343-0546
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038009100Medicaid
ILL96939Medicare PIN