Provider Demographics
NPI:1205541414
Name:CREEK CHIROPRACTIC, INC
Entity type:Organization
Organization Name:CREEK CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:D
Authorized Official - Last Name:STONITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-668-9675
Mailing Address - Street 1:29420 PLAUTZ RD
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-9496
Mailing Address - Country:US
Mailing Address - Phone:815-668-9675
Mailing Address - Fax:815-364-2776
Practice Address - Street 1:29420 PLAUTZ RD
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-9496
Practice Address - Country:US
Practice Address - Phone:815-668-9675
Practice Address - Fax:815-364-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962571679OtherINDIVIDUAL NPI #