Richard M. Novak, Dc Pc | |
4a Oak Dr, Maryville, IL 62062-5809 | |
(618) 288-8075 | |
Not Available |
Full Name | Richard M. Novak, Dc Pc |
---|---|
Type | Facility |
Speciality | Chiropractor - Rehabilitation |
Location | 4a Oak Dr, Maryville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992854814 | NPI | - | NPPES |
209673 | Other | IL | MEDICARE |
DG4136 | Other | IL | RAILROAD MEDICARE |
37-1395118 | Other | IL | TAX ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NR0400X | Chiropractor - Rehabilitation | (* (Not Available)) | Primary |
Provider Name | Richard M Novak |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1083619449 PECOS PAC ID: 1557337086 Enrollment ID: I20040908000566 |
Mailing Address | Practice Location Address |
---|---|
Richard M. Novak, Dc Pc 4a Oak Dr, Maryville, IL 62062-5809 Ph: (618) 288-8075 | Richard M. Novak, Dc Pc 4a Oak Dr, Maryville, IL 62062-5809 Ph: (618) 288-8075 |
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