Healthcare Provider Details

I. General information

NPI: 1417814799
Provider Name (Legal Business Name): TALON FILE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 VARSITY CT APT B
SPRINGFIELD IL
62712-4213
US

IV. Provider business mailing address

2620 VARSITY CT APT B
SPRINGFIELD IL
62712-4213
US

V. Phone/Fax

Practice location:
  • Phone: 217-725-9797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014414
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: