Provider Demographics
NPI:1235338674
Name:STROOT CHIROPRACTIC
Entity Type:Organization
Organization Name:STROOT CHIROPRACTIC
Other - Org Name:THOMAS N. STROOT DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:NAYLOR
Authorized Official - Last Name:STROOT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-688-8773
Mailing Address - Street 1:3227 N PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61603-1544
Mailing Address - Country:US
Mailing Address - Phone:309-688-8773
Mailing Address - Fax:309-688-8791
Practice Address - Street 1:3227 N PROSPECT RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-1544
Practice Address - Country:US
Practice Address - Phone:309-688-8773
Practice Address - Fax:309-688-8791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1558377127OtherPERSONAL NPI
ILT35787Medicare UPIN
IL1558377127OtherPERSONAL NPI