| Central Il Spine | |
|
1603 Visa Dr, Normal, IL 61761-2131 | |
| (309) 268-9000 | |
| (309) 268-9003 |
| Full Name | Central Il Spine |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1603 Visa Dr, Normal, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467574731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 038.009648 (Illinois) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | 038.009648 (Illinois) | Secondary |
| Provider Name | Jeffrey L Dickhut |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1235325200 PECOS PAC ID: 6608862214 Enrollment ID: I20040421000238 |
| Provider Name | Jay M Bersche |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306876511 PECOS PAC ID: 8426096637 Enrollment ID: I20050419000842 |
| Provider Name | John M Everingham |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1972687457 PECOS PAC ID: 5698832590 Enrollment ID: I20090320000118 |
| Provider Name | Hong X Vo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447419940 PECOS PAC ID: 6305070558 Enrollment ID: I20131002000149 |
| Provider Name | Erin Elizabeth Gambetti |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063898765 PECOS PAC ID: 6204135718 Enrollment ID: I20180416001979 |
| Provider Name | Carolyn Hagerty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942954169 PECOS PAC ID: 0840666194 Enrollment ID: I20221012000965 |
| Mailing Address | Practice Location Address |
|---|---|
| Central Il Spine 1603 Visa Dr, Normal, IL 61761-2131 Ph: (309) 268-9000 | Central Il Spine 1603 Visa Dr, Normal, IL 61761-2131 Ph: (309) 268-9000 |
Ms. Kendra Shana' Stewart, Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 214 S Linden St, Normal, IL 61761 Phone: 309-454-8622 | |
Ryan Joseph Mclaughlin, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 211 Landmark, Suite A2, Normal, IL 61761 Phone: 309-454-2500 Fax: 309-454-2565 | |
Dr. Stephen J Troyanovich, DC Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 322 Susan Dr, Ste B, Normal, IL 61761 Phone: 309-454-5556 Fax: 309-454-5669 | |
Dr. Jeffrey Lee Dickhut, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1603 Visa Dr, Suite 3, Normal, IL 61761 Phone: 309-268-9000 Fax: 309-268-9003 | |
Mr. John L. Zozzaro Jr., D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 1713 Fort Jesse Rd, Suite D, Normal, IL 61761 Phone: 309-862-2225 Fax: 309-862-2229 | |
Dr. Jay M Bersche, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1603 Visa Dr, Normal, IL 61761 Phone: 309-269-9000 Fax: 309-268-9003 | |
Dr. Timothy Joseph Griesbaum, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1607 Visa Dr, 1a, Normal, IL 61761 Phone: 309-268-9888 Fax: 309-268-9887 |