MEDICARE: ATKINS CHIROPRATIC TREATMENT, LLC

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	038.010778	IL

General Provider Information

NPI Number	:	1952556086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATKINS CHIROPRATIC TREATMENT, LLC

Provider Business Mailing Address
First Line	:	1853 S MAIN ST STE B
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3583
Country	:	US
Telephone Number	:	217-243-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1853 S MAIN ST STE B
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3583
Country	:	US
Telephone Number	:	217-243-5700
Fax Number	:	217-243-5711

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID M ATKINS
Credential	:	D.C.
Telephone Number	:	217-243-5700

Provider Enumeration Date	:	11/17/2008
Last Update Date	:	11/17/2008

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