Provider Demographics
NPI:1184998023
Name:SELECT HEALTH CHIROPRACTIC LTD.
Entity type:Organization
Organization Name:SELECT HEALTH CHIROPRACTIC LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEELENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-690-4223
Mailing Address - Street 1:1450 W MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1679
Mailing Address - Country:US
Mailing Address - Phone:630-377-2077
Mailing Address - Fax:630-377-2088
Practice Address - Street 1:1450 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1679
Practice Address - Country:US
Practice Address - Phone:630-377-2077
Practice Address - Fax:630-377-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty