Individual
DR. JOHN L PROCOPIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2617 45TH ST, HIGHLAND, IN 46322-2902
(219) 924-4457
(219) 924-7301
Mailing address
2625 45TH ST, HIGHLAND, IN 46322-2902
(219) 924-4457
(219) 924-7301
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001186A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089157
ANTHEM PROVIDER NUMBER
IN
05
—
100148230A
—
IN
01
—
35-1865859
TAX ID
IN
01
—
4667347
AETNA PROVIDER #
IN
01
—
90000629
BLUECROSSBLUESHIELD ID#
IL
Enumeration date
07/07/2005
Last updated
05/25/2021
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