Provider Demographics
NPI:1225732977
Name:STONITSCH HEALTH AND BODY WELLNESS
Entity Type:Organization
Organization Name:STONITSCH HEALTH AND BODY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STONITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-626-1887
Mailing Address - Street 1:3502 PROPHET RD
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-2446
Mailing Address - Country:US
Mailing Address - Phone:815-441-7274
Mailing Address - Fax:815-626-9602
Practice Address - Street 1:808 W ROUTE 30
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-2766
Practice Address - Country:US
Practice Address - Phone:815-626-1887
Practice Address - Fax:815-626-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1265501704OtherNPPES