| |
101 East Second Street, Unit 2, Big Rock, IL 60511-0173 | |
(630) 479-9355 | |
(630) 566-1633 |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor - Internist |
Location | 101 East Second Street, Big Rock, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295943108 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NI0900X | Chiropractor - Internist | 038006687 (Illinois) | Primary |
111NN1001X | Chiropractor - Nutrition | 038006687 (Illinois) | Secondary |
Mailing Address | Practice Location Address |
---|---|
4082 River Rdg, Sandwich, IL 60548-6905 Ph: (630) 479-9355 | 101 East Second Street, Unit 2, Big Rock, IL 60511-0173 Ph: (630) 479-9355 |