MEDICARE: TUSCOLA PAIN & WELLNESS CENTER SC

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	038006250	IL

General Provider Information

NPI Number	:	1396856688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUSCOLA PAIN & WELLNESS CENTER SC

Provider Business Mailing Address
First Line	:	902 S COURT SUITE 2
Second Line	:
City	:	TUSCOLA
State	:	IL
Zip	:	61953
Country	:	US
Telephone Number	:	217-253-2370
Fax Number	:	217-253-6545

Provider Business Practice Location Address
First Line	:	902 S COURT SUITE 2
Second Line	:
City	:	TUSCOLA
State	:	IL
Zip	:	61953
Country	:	US
Telephone Number	:	217-253-2370
Fax Number	:	217-253-6545

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM G HEMMER
Credential	:	DC
Telephone Number	:	217-253-2370

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/07/2020

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