Cynthia Dawn Treharne, D.C., P.A.

Individual provider Active NPI Chiropractor · Fulton, IL

NPI 1801973128 · NPPES record last updated Aug 19, 2013

Key facts

NPI
1801973128
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
038-010663 (IL)
Practice address
1106 4TH St
Fulton, IL 61252-1718
Phone
(815) 589-5255
Fax
(309) 786-7980
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
038-010663ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Holdings, LLC Chiropractor Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010663 IL Yes
Medical Physician Assistant 363AM0700X 085001604 IL
Medical Physician Assistant 363AM0700X 001363 IA

Addresses

Primary practice location

1106 4TH St
Fulton, IL 61252-1718

Mailing address

1106 4TH St
Fulton, IL 61252-1718
Phone (815) 589-5255

Other providers in Fulton, IL

All providers in Fulton, IL · Chiropractor in Illinois

Sources for this page

Verify at the official NPI Registry.