Provider Demographics
NPI:1427212349
Name:AMADOR CHIROPRACTIC LIMITED
Entity Type:Organization
Organization Name:AMADOR CHIROPRACTIC LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-792-6090
Mailing Address - Street 1:920 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-1047
Mailing Address - Country:US
Mailing Address - Phone:309-792-6030
Mailing Address - Fax:309-792-6095
Practice Address - Street 1:920 1ST AVE
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-1047
Practice Address - Country:US
Practice Address - Phone:309-792-6030
Practice Address - Fax:309-792-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL351820Medicare PIN
IL561560Medicare PIN