Provider Demographics
NPI:1619092806
Name:REICHLING, STEVEN EARL (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:EARL
Last Name:REICHLING
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 1:7100 WEST MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-3022
Mailing Address - Country:US
Mailing Address - Phone:618-394-1755
Mailing Address - Fax:618-394-1789
Practice Address - Street 1:7100 WEST MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-3022
Practice Address - Country:US
Practice Address - Phone:618-394-1755
Practice Address - Fax:618-394-1755
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8225367OtherBLUE CROSS BLUE SHIELD
350037345Medicare ID - Type UnspecifiedRAILROAD
IL8225367OtherBLUE CROSS BLUE SHIELD
232800Medicare ID - Type Unspecified