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BLOOMINGTON CHIROPRACTIC CENTER LTD. NPI 1487833992


NPI Information

NPI: 1487833992
Provider Name: BLOOMINGTON CHIROPRACTIC CENTER, LTD.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
409 S PROSPECT RD
SUITE A
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 663-8388
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BLOOMINGTON CHIROPRACTIC CENTER, LTD. is a clinic center in Bloomington, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BLOOMINGTON CHIROPRACTIC CENTER, LTD. NPI is 1487833992. The provider is registered as an organization entity type.

The provider's business location address is:

409 S PROSPECT RD
SUITE A
BLOOMINGTON, IL
ZIP 61704-581
Phone: (309) 663-8388
Fax: (309) 663-0929

The provider's authorized official is John M Everingham .
The authorized official title is Senior Assoicate and has the following contact phone number (309) 663-8388.

The enumeration date for this NPI number is 10/31/2007 and was last updated on 10/31/2007.


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
1261Q00000XClinic/Center060002911- 038007235ILLINOISYes

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
1L55004MEDICARE UPINILLINOIS
25715397OTHERILLINOISBLUE CROSS / BLUE SHIED
3395230MEDICARE PINILLINOIS

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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