Provider Demographics
NPI:1497725113
Name:PILLER, CHAD MONROE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MONROE
Last Name:PILLER
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 1:227 E RT 38
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068
Mailing Address - Country:US
Mailing Address - Phone:815-562-8706
Mailing Address - Fax:815-562-3251
Practice Address - Street 1:227 E RT 38
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068
Practice Address - Country:US
Practice Address - Phone:815-562-8706
Practice Address - Fax:815-562-3251
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038007738Medicaid
U57667Medicare UPIN
IL226570Medicare ID - Type Unspecified