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NPI Code Detail

MEDICARE: DR. TODD ANTHONY GILL D.C.

MEDICARE: DR. TODD ANTHONY GILL D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NS0005XSports Physician Chiropractor038-008367IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1350051877OTHERILRAILROAD MEDICARE

General Provider Information

NPI Number : 1063477263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD ANTHONY GILL D.C.
Provider Business Mailing Address
First Line : 616 N MARKET ST
Second Line :
City : MOUNT CARMEL
State : IL
Zip : 62863-1459
Country : US
Telephone Number : 618-262-2225
Fax Number : 618-262-2880
Provider Business Practice Location Address
First Line : 616 N MARKET ST
Second Line :
City : MOUNT CARMEL
State : IL
Zip : 62863-1459
Country : US
Telephone Number : 618-262-2225
Fax Number : 618-262-2880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 09/09/2010

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