Provider Demographics
NPI:1598224909
Name:CHIROPRO OF HIGHLAND, LLC
Entity Type:Organization
Organization Name:CHIROPRO OF HIGHLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-979-0398
Mailing Address - Street 1:1231 THOUVENOT LN # 100
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:208 FLAX DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1375
Practice Address - Country:US
Practice Address - Phone:618-651-6310
Practice Address - Fax:618-651-6315
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHILOH CHIROPRACTIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-15
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty