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ICAN CLINIC LLC NPI 1669722872


NPI Information

NPI: 1669722872
Provider Name: ICAN CLINIC LLC

Doing Business As: WOOD RIVER CHIROPRACTIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
441 S STATE ROUTE 157 STE 102
EDWARDSVILLE, IL
ZIP 62025
Phone: (618) 254-2273
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ICAN CLINIC LLC is a multi-specialty clinic center in Edwardsville, IL. ICAN CLINIC LLC NPI is 1669722872. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wood River Chiropractic.

The provider's business location address is:

441 S STATE ROUTE 157 STE 102
EDWARDSVILLE, IL
ZIP 62025-017
Phone: (618) 254-2273
Fax: (618) 254-8476

The provider's authorized official is Michael S Harbison .
The authorized official title is Owner/director and has the following contact phone number (618) 254-2273.

The enumeration date for this NPI number is 9/14/2012 and was last updated on 8/3/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor038.12178ILLINOISNo
2111N00000XChiropractorNo
3207Q00000XFamily MedicineNo
42081P2900XPhysical Medicine & RehabilitationPain MedicineNo
5261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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