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General NPI Number Information
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NPI Number | 1275655060
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Entity Type | Organization
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Legal Business Name | HUGGINS CHIROPRACTIC AND ACUPUNCTURECLINICLTD
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 25 GREEN BAY RD STE B
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City | LAKE BLUFF
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State | IL
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Zip | 60044-2301
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Country | US
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Telephone | 847-482-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 GREEN BAY RD STE B
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City | LAKE BLUFF
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State | IL
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Zip | 60044-2301
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Country | US
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Telephone | 847-482-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARYLLON CUMMINGS HUGGINS
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Credential | DC,DACBN,CCN,CCSP,
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Telephone | 847-482-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38007518
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 38007518
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 38007518
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38007518
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License Number State | IL
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