John Alan Loucks, DC
Individual provider Active NPI Chiropractor · Geneseo, IL
NPI 1841290954 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1841290954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38-3525 (IL)
- Practice address
- 613 E Ogden Ave
Geneseo, IL 61254-1101 - Phone
- (309) 944-4599
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38-3525 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38-3525 | IL | Yes |
Addresses
Primary practice location
613 E Ogden Ave
Geneseo, IL 61254-1101
Mailing address
613 E Ogden Ave
Geneseo, IL 61254-1101
Phone (309) 944-4599
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982020 | Other | IL | BLUE SHIELD |
Other providers in Geneseo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.