Individual
DR. JEFFREY LEE DICKHUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1603 VISA DR, SUITE 3, NORMAL, IL 61761-2151
(309) 268-9000
(309) 268-9003
Mailing address
1603 VISA DR, SUITE 3, NORMAL, IL 61761-2151
(309) 268-9000
(309) 268-9003
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009648
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732057
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/24/2007
Last updated
05/12/2022
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