Provider Demographics
NPI:1497702385
Name:BEMIS, F RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:F
Middle Name:RYAN
Last Name:BEMIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 REGIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5942
Mailing Address - Country:US
Mailing Address - Phone:618-433-9333
Mailing Address - Fax:618-433-9663
Practice Address - Street 1:230 REGIONAL DR
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5942
Practice Address - Country:US
Practice Address - Phone:618-433-9333
Practice Address - Fax:618-433-9663
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10529T1OtherBCBS ALLIANCE
IL038008413Medicaid
IL4400037OtherUNITED HEALTH CARE
IL5161604OtherAETNA HEALTHCARE
IL279245500OtherFED. EMPLOYEE
MO114579OtherBCBS MISSOURI
IL111407OtherHEALTHLINK
IL6082010OtherBLUE CROSS BLUE SHEILD
IL279245500OtherFED. EMPLOYEE
IL111407OtherHEALTHLINK