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KOMESHAK CHIROPRACTIC LTD NPI 1437249158


NPI Information

NPI: 1437249158
Provider Name: KOMESHAK CHIROPRACTIC LTD
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
3030 FRANK SCOTT PKWY W
SUITE 1
BELLEVILLE, IL
ZIP 62223
Phone: (618) 236-3600
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KOMESHAK CHIROPRACTIC LTD is a chiropractor in Belleville, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. KOMESHAK CHIROPRACTIC LTD NPI is 1437249158. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3030 FRANK SCOTT PKWY W
SUITE 1
BELLEVILLE, IL
ZIP 62223-014
Phone: (618) 236-3600
Fax: (618) 236-3600

The provider's authorized official is Patrick Komeshak .
The authorized official title is Owner and has the following contact phone number (618) 236-3600.

The enumeration date for this NPI number is 10/13/2006 and was last updated on 2/25/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical Therapist070011807ILLINOISNo
2111N00000XChiropractor038008047ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1104259OTHERGHP
2211930MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE ILLINOIS
308221308OTHERILLINOISBCBS ILLINOIS
4DD4196OTHERMEDICARE RAILROAD

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: 11/14/2023

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