Individual
CRAIG A. REVERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
397 N PLUM ST, BREESE, IL 62230-1528
(618) 526-4700
(618) 526-4702
Mailing address
397 N PLUM ST, BREESE, IL 62230-1528
(618) 526-4700
(618) 526-4702
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
627838
UHC
IL
01
—
P00110681
MEDICARE RAILROAD
IL
Enumeration date
07/01/2005
Last updated
09/07/2007
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