MEDICARE: STEPHEN L. HUTTI & MARK E. HUTTI PTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038003918/038004010	IL

General Provider Information

NPI Number	:	1033119185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN L. HUTTI & MARK E. HUTTI PTR

Provider Business Mailing Address
First Line	:	655 W LINCOLN AVE
Second Line	:	SUITE 2
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2426
Country	:	US
Telephone Number	:	217-348-1450
Fax Number	:	217-348-1451

Provider Business Practice Location Address
First Line	:	655 W LINCOLN AVE
Second Line	:	SUITE 2
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2426
Country	:	US
Telephone Number	:	217-348-1450
Fax Number	:	217-348-1451

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	DR. STEPHEN L HUTTI
Credential	:	D.C.
Telephone Number	:	217-348-1450

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	01/07/2008

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