Provider Demographics
NPI:1477649051
Name:STENZEL, AMBER LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LYNN
Last Name:STENZEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:LYNN
Other - Last Name:RIEBELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:110 S MARKET
Mailing Address - Street 2:PO BOX 196
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298
Mailing Address - Country:US
Mailing Address - Phone:618-939-3411
Mailing Address - Fax:618-939-3411
Practice Address - Street 1:110 S MARKET
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298
Practice Address - Country:US
Practice Address - Phone:618-939-3411
Practice Address - Fax:618-939-3411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06732005OtherBLUE CROSS BLUE SHIELD
IL511483OtherHEALTHLINK
ILP00405007OtherRAILROAD MEDICARE
203735Medicare ID - Type Unspecified