Provider Demographics
NPI:1205812096
Name:SPEH, ERIC M (DC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:M
Last Name:SPEH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511A STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5149
Mailing Address - Country:US
Mailing Address - Phone:618-466-2000
Mailing Address - Fax:618-466-2020
Practice Address - Street 1:2511STATE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5149
Practice Address - Country:US
Practice Address - Phone:618-466-2000
Practice Address - Fax:618-466-2020
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038009456Medicaid
IL6028257OtherBCBS
IL35005314OtherRAILROAD MEDICARE
IL467607OtherHEALTHLINK
IL467607OtherHEALTHLINK