| Acupuncture & Chiropractic Center | |
|
716 S 2nd St Springfield IL 62704-2516 | |
| (217) 544-8118 | |
| Not Available |
| Full Name | Acupuncture & Chiropractic Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 716 S 2nd St, Springfield, Illinois |
| Authorized Official Name and Position | Louis T Distasio (OWNER) |
| Authorized Official Contact | 2175448118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acupuncture & Chiropractic Center 716 S 2nd St Springfield IL 62704-2516 Ph: () - | Acupuncture & Chiropractic Center 716 S 2nd St Springfield IL 62704-2516 Ph: (217) 544-8118 |
| NPI Number | 1336417724 |
|---|---|
| Provider Enumeration Date | 12/13/2011 |
| Last Update Date | 12/13/2011 |
| Medicare PECOS PAC ID | 0547422230 |
|---|---|
| Medicare Enrollment ID | O20120425000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336417724 | NPI | - | NPPES |
| 8482034 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 038003935 (Illinois) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | 198000025 (Illinois) | Secondary |
| Provider Name | Louis T Distasio |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1629153085 PECOS PAC ID: 3476514464 Enrollment ID: I20041022000702 |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2833 S Grand Ave E, Springfield, IL 62703 Phone: 221-753-5310 Fax: 217-789-2069 | |
Professional Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000 | |
Hshs Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3215 Executive Park Dr, Springfield, IL 62703 Phone: 217-523-5406 | |
Michael Bova M D S C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2524 Farragut Dr, Suite C, Springfield, IL 62704 Phone: 217-726-9346 | |
North Dirksen Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3220 Atlanta St, Springfield, IL 62707 Phone: 217-588-7400 | |
Siu Physicians & Surgeons, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 N 1st St, D235, Springfield, IL 62781 Phone: 217-545-7578 Fax: 217-545-1884 | |
B3 Healthcare Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 E Madison St Ste 2d, Springfield, IL 62701 Phone: 217-508-5859 |