Healthcare Provider Details

I. General information

NPI: 1861571663
Provider Name (Legal Business Name): DAVID R HEPLER II DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PULASKI STREET
LINCOLN IL
62656
US

IV. Provider business mailing address

PO BOX 507
LINCOLN IL
62656
US

V. Phone/Fax

Practice location:
  • Phone: 217-735-4451
  • Fax: 217-732-2445
Mailing address:
  • Phone: 217-735-4451
  • Fax: 217-732-2445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038004674
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: