Provider Demographics
NPI:1114363173
Name:RITCHIE CHIROPRACTIC, LTD.
Entity Type:Organization
Organization Name:RITCHIE CHIROPRACTIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RITCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-446-5000
Mailing Address - Street 1:3 1/2 POLAND RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61834-7463
Mailing Address - Country:US
Mailing Address - Phone:217-446-5000
Mailing Address - Fax:217-446-6409
Practice Address - Street 1:3 1/2 POLAND RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61834-7463
Practice Address - Country:US
Practice Address - Phone:217-446-5000
Practice Address - Fax:217-446-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL622220Medicare PIN
ILU82998Medicare UPIN