Physician Compare National (NPI:1487008272)

HEALTHCARE PROVIDER: CAMERON ROBERT MACKICHAN D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1487008272
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4486913423
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180119000282
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MACKICHAN
	Individual professional last name
Provider First Name	CAMERON
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOGAN COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2003 ROUND BARN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	CHAMPAIGN
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	618216828
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M