Provider Demographics
NPI:1235204686
Name:DR WILLIAM N BYRKIT JR PC
Entity Type:Organization
Organization Name:DR WILLIAM N BYRKIT JR PC
Other - Org Name:BYRKIT CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:BYRKIT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:618-344-2501
Mailing Address - Street 1:1280 VANDALIA STREET
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234
Mailing Address - Country:US
Mailing Address - Phone:618-344-2501
Mailing Address - Fax:618-344-2554
Practice Address - Street 1:1280 VANDALIA ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4024
Practice Address - Country:US
Practice Address - Phone:618-344-2501
Practice Address - Fax:618-344-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038003310Medicaid
IL06082012OtherBCBS
IL791350047OtherRR MEDICARE
IL292570Medicare PIN
T36081Medicare UPIN