Provider Demographics
NPI:1891830923
Name:ADVANTAGE FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:ADVANTAGE FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-582-2422
Mailing Address - Street 1:802 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:IL
Mailing Address - Zip Code:61231-1861
Mailing Address - Country:US
Mailing Address - Phone:309-582-2422
Mailing Address - Fax:309-582-2425
Practice Address - Street 1:802 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:IL
Practice Address - Zip Code:61231-1861
Practice Address - Country:US
Practice Address - Phone:309-582-2422
Practice Address - Fax:309-582-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06626451OtherBLUECROSS BLUESHIELD IL
ILU80128Medicare UPIN
IL06626451OtherBLUECROSS BLUESHIELD IL