MEDICARE: DR. CAROL L HOURIGAN DC

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180864	OTHER		HEALTHLINK
2	2582007	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1790888246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL L HOURIGAN DC

Provider Business Mailing Address
First Line	:	511 WEST VIRGINIA AVE
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2261
Country	:	US
Telephone Number	:	217-347-7070
Fax Number	:	217-347-6670

Provider Business Practice Location Address
First Line	:	511 WEST VIRGINIA AVE
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2261
Country	:	US
Telephone Number	:	217-347-7070
Fax Number	:	217-347-7074

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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