Individual
DR. JOHN MARVIN EVERINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1603 VISA DR, NORMAL, IL 61761-2131
(309) 268-9000
(309) 268-9003
Mailing address
1603 VISA DR, NORMAL, IL 61761-2131
(309) 268-9000
(309) 268-9003
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-005103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5715397
BCBS OF ILLINOIS
IL
Enumeration date
10/24/2006
Last updated
05/19/2020
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