Individual
MARK D WHITEHEAD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2103 W MAIN ST, MARION, IL 62959-1163
(618) 997-5000
Mailing address
2103 W MAIN ST, MARION, IL 62959-1163
(618) 997-5000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043166
HEALTH ALLIANCE
IL
01
—
100-05426
BLUECROSS/BLUESHIELD
IL
01
—
179254
HEALTHLINK PPO
IL
Enumeration date
04/07/2006
Last updated
07/08/2007
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