Provider Demographics
NPI:1740396407
Name:AL PEORIA, LLC
Entity Type:Organization
Organization Name:AL PEORIA, LLC
Other - Org Name:DBA ALIGNLIFE OF PEORIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-453-8500
Mailing Address - Street 1:4812 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-5928
Mailing Address - Country:US
Mailing Address - Phone:309-689-6200
Mailing Address - Fax:309-689-6219
Practice Address - Street 1:4812 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-5928
Practice Address - Country:US
Practice Address - Phone:309-689-6200
Practice Address - Fax:309-689-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty