Provider Demographics
NPI:1619235967
Name:STRINGER CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:STRINGER CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:STRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-355-8800
Mailing Address - Street 1:2905 W SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-2801
Mailing Address - Country:US
Mailing Address - Phone:217-355-8800
Mailing Address - Fax:217-355-8807
Practice Address - Street 1:2905 W SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-2801
Practice Address - Country:US
Practice Address - Phone:217-355-8800
Practice Address - Fax:217-355-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007635261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU58274Medicare UPIN