Healthcare Provider Details

I. General information

NPI: 1841385945
Provider Name (Legal Business Name): HOVI CLINIC OF CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N SEMINARY AVE STE K
WOODSTOCK IL
60098-2980
US

IV. Provider business mailing address

1400 N SEMINARY AVE SUITE K
WOODSTOCK IL
60098-2980
US

V. Phone/Fax

Practice location:
  • Phone: 815-338-9150
  • Fax: 815-337-0279
Mailing address:
  • Phone: 815-338-9150
  • Fax: 815-337-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038004872
License Number StateIL

VIII. Authorized Official

Name: DR. LUCINDA JEAN HOVI
Title or Position: PRESIDENT
Credential: DC
Phone: 815-338-9150