Provider Demographics
NPI:1184893885
Name:PIRIE CHIROPRACTIC CENTER, LTD
Entity type:Organization
Organization Name:PIRIE CHIROPRACTIC CENTER, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-725-8345
Mailing Address - Street 1:1011 ESSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2869
Mailing Address - Country:US
Mailing Address - Phone:815-725-8345
Mailing Address - Fax:815-725-8310
Practice Address - Street 1:1011 ESSINGTON RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2869
Practice Address - Country:US
Practice Address - Phone:815-725-8345
Practice Address - Fax:815-725-8310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IL038009041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDP1289OtherRAILROAD MEDICARE
IL9932048OtherBCBSI
IL203928Medicare PIN