Provider Demographics
NPI:1548231194
Name:WOODROW, CHRISTOPHER JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:WOODROW
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 1:103 E ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1272
Mailing Address - Country:US
Mailing Address - Phone:217-864-5566
Mailing Address - Fax:217-864-4497
Practice Address - Street 1:103 E ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:MT ZION
Practice Address - State:IL
Practice Address - Zip Code:62549-1272
Practice Address - Country:US
Practice Address - Phone:217-864-5566
Practice Address - Fax:217-864-4497
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038006572Medicaid
ILK51241Medicare PIN
IL913451Medicare PIN
ILT37629Medicare UPIN