Doctor Name: | DR. JEFFREY LEE DICKHUT |
NPI Number: | 1235325200 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 038-009648 |
Business Practice Address: | 1603 Visa Dr Suite 3 Normal, IL - 617612151 |
Business Phone Number: | 3092689000 |
Business Fax Number: | 3092689003 |
Mailing Address: | 1603 Visa Dr, Suite 3 NORMAL |
State: | IL |
Postal Code: | 617612151 |
Phone Number: | 3092689000 |
Fax Number: | 3092689003 |
NPI Enumeration Date: | 09/24/2007 |
NPI Last Update Date: | 09/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 038-009648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |