Provider Demographics
NPI:1780182279
Name:RHEINECKER CHIROPRACTIC CARE PC
Entity Type:Organization
Organization Name:RHEINECKER CHIROPRACTIC CARE PC
Other - Org Name:RHEINECKER CHIROPRACTIC CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RHEINECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-965-9555
Mailing Address - Street 1:108 N SPARTA ST
Mailing Address - Street 2:
Mailing Address - City:STEELEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62288-1541
Mailing Address - Country:US
Mailing Address - Phone:618-965-9555
Mailing Address - Fax:618-965-9556
Practice Address - Street 1:108 N SPARTA ST
Practice Address - Street 2:
Practice Address - City:STEELEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62288-1541
Practice Address - Country:US
Practice Address - Phone:618-965-9555
Practice Address - Fax:618-965-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty