# CENTRAL ILLINOIS CHIROPRACTIC, P.C.

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

## Provider details

- **NPI number:** 1558379115
- **Authorized official:** DR. MICHAEL DUANE FUNK DC (OWNER)
- **Authorized official phone:** (309) 346-8008

## Contact information

- **Practice address:** 1030 COURT ST, PEKIN, IL 61554-4806
- **Practice address phone:** (309) 346-8008
- **Practice address fax:** (309) 346-8009
- **Mailing address:** 1030 COURT ST, PEKIN, IL 61554-4806
- **Mailing address phone:** (309) 346-8008
- **Mailing address fax:** (309) 346-8009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 060006218 | IL | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 02/05/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09015695 | BLUE CROSS | IL |