Provider Demographics
NPI:1518284769
Name:STRATTON CHIROPRACTIC AND FAMILY HEALTH CENTER P.C.
Entity Type:Organization
Organization Name:STRATTON CHIROPRACTIC AND FAMILY HEALTH CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CACCP
Authorized Official - Phone:618-939-5585
Mailing Address - Street 1:343 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298-1338
Mailing Address - Country:US
Mailing Address - Phone:618-939-5585
Mailing Address - Fax:618-939-2099
Practice Address - Street 1:343 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-1338
Practice Address - Country:US
Practice Address - Phone:618-939-5585
Practice Address - Fax:618-939-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008800111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06725377OtherBCBS OF ILLINOIS
MO155541OtherBCBS OF MISSOURI
IL44-00540OtherUNITED HEALTHCARE
MO120511OtherHEALTHLINK
MO120511OtherHEALTHLINK