Provider Demographics
NPI:1952367872
Name:ROHDEMANN, AARON DWIGHT (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:DWIGHT
Last Name:ROHDEMANN
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 1:1601 W MAIN ST
Mailing Address - Street 2:PO BOX 641
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62565-9571
Mailing Address - Country:US
Mailing Address - Phone:217-774-1070
Mailing Address - Fax:217-774-1070
Practice Address - Street 1:1601 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-9571
Practice Address - Country:US
Practice Address - Phone:217-774-1070
Practice Address - Fax:217-774-1070
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08732004OtherBLUE CROSS/BLUE SHIELD
ILP00162584OtherRAILROAD MEDICARE #
IL038-010076Medicaid
IL038-010076Medicaid