# HEALTHSOURCE CHIROPRACTIC OF CHAMPAIGN, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023556164
- **Authorized official:** DR. CAMERON ROBERT MACKICHAN D.C. (OWNER)
- **Authorized official phone:** (217) 281-0006

## Contact information

- **Practice address:** 2003 ROUND BARN RD, SUITE B, CHAMPAIGN, IL 61821-6827
- **Practice address phone:** (217) 281-0006
- **Mailing address:** 2003 ROUND BARN RD, SUITE B, CHAMPAIGN, IL 61821-6827
- **Mailing address phone:** (217) 281-0006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 038.012800 | IL | Yes |

## Other

- **Enumeration date:** 02/09/2017
- **Last updated:** 01/16/2018