Provider Demographics
NPI:1982899225
Name:AUGHENBAUGH FAMILY CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:AUGHENBAUGH FAMILY CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:AUGHENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-393-4114
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:EARLVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60518-0174
Mailing Address - Country:US
Mailing Address - Phone:815-246-8611
Mailing Address - Fax:152-468-6218
Practice Address - Street 1:139 W RAILROAD ST
Practice Address - Street 2:
Practice Address - City:EARLVILLE
Practice Address - State:IL
Practice Address - Zip Code:60518-3119
Practice Address - Country:US
Practice Address - Phone:815-246-8611
Practice Address - Fax:815-246-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL512070Medicare PIN
ILU72694Medicare UPIN