Provider Demographics
NPI:1982822292
Name:DAVID D. REHBERGER DC LTD
Entity Type:Organization
Organization Name:DAVID D. REHBERGER DC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DARYL
Authorized Official - Last Name:REHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-654-8514
Mailing Address - Street 1:520 SUPPIGER WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1101
Mailing Address - Country:US
Mailing Address - Phone:618-654-8514
Mailing Address - Fax:616-654-8511
Practice Address - Street 1:520 SUPPIGER WAY
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1101
Practice Address - Country:US
Practice Address - Phone:618-654-8514
Practice Address - Fax:616-654-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
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
ILT35457Medicare UPIN
IL232680Medicare ID - Type Unspecified