| Illinois Valley Chiropractic, Ltd | |
|
501 1st St, La Salle, IL 61301-2416 | |
| (815) 223-4201 | |
| (815) 223-4210 |
| Full Name | Illinois Valley Chiropractic, Ltd |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 501 1st St, La Salle, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679883185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NS0005X | Chiropractor - Sports Physician | 038.008373 (Illinois) | Primary |
| Provider Name | Glen R Peterson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1437209418 PECOS PAC ID: 9335337450 Enrollment ID: I20101216000062 |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Valley Chiropractic, Ltd Po Box 1204, La Salle, IL 61301-3204 Ph: (815) 223-4201 | Illinois Valley Chiropractic, Ltd 501 1st St, La Salle, IL 61301-2416 Ph: (815) 223-4201 |
Mr. William L Judge, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 130 3rd St, La Salle, IL 61301 Phone: 815-223-0647 Fax: 815-223-0987 | |
William L. Judge Chiropractic Center, Pc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 130 3rd St, La Salle, IL 61301 Phone: 815-223-0647 Fax: 815-223-0987 | |
Dr. Michael James Gergovich, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 130 3rd St, La Salle, IL 61301 Phone: 815-223-0647 Fax: 815-223-0987 | |
Mr. Patrick R Smith, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 130 3rd St, La Salle, IL 61301 Phone: 815-223-0647 Fax: 815-223-0987 | |
Dr. Glen R Peterson, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 501 1st St, La Salle, IL 61301 Phone: 815-223-4201 Fax: 814-223-4210 | |
Gergovich Family Chiropractic, Llc. Chiropractor Medicare: Medicare Enrolled Practice Location: 130 3rd St, La Salle, IL 61301 Phone: 815-223-0647 Fax: 815-223-0987 |