Provider Demographics
NPI:1871622639
Name:HANKINS, D. WILLIAM (DC)
Entity type:Individual
Prefix:
First Name:D. WILLIAM
Middle Name:
Last Name:HANKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 TOWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3454
Mailing Address - Country:US
Mailing Address - Phone:309-829-1010
Mailing Address - Fax:309-820-0142
Practice Address - Street 1:1210 TOWANDA AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3454
Practice Address - Country:US
Practice Address - Phone:309-829-1010
Practice Address - Fax:309-820-0142
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL216611Medicare ID - Type Unspecified