Individual
DR. MARK W. WADE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
295 N BROAD ST, CARLINVILLE, IL 62626-1301
(217) 854-8211
(217) 854-3636
Mailing address
295 N BROAD ST, CARLINVILLE, IL 62626-1301
(217) 854-8211
(217) 854-3636
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005982011
BLUECROSS BLUESHIELD
IL
Enumeration date
05/12/2006
Last updated
07/08/2007
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