MEDICARE: DR. KARL P SCHIPPEL 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
1	111N00000X	Chiropractor		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	391375	OTHER	IL	HEALTHLINK
2	06922750	OTHER	IL	BLUE CROSS AND BLUE SHIEL
3	045216	OTHER	IL	HEALTH ALLIANCE
4	1194855	OTHER	IL	FIRST HEALTH

General Provider Information

NPI Number	:	1912049727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL P SCHIPPEL D.C.

Provider Business Mailing Address
First Line	:	1429 S MAIN ST
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3476
Country	:	US
Telephone Number	:	217-245-9797
Fax Number	:	217-245-2524

Provider Business Practice Location Address
First Line	:	1429 S MAIN ST
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3476
Country	:	US
Telephone Number	:	217-245-9797
Fax Number	:	217-245-2524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/08/2007

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