Provider Demographics
NPI:1205903788
Name:R & J HEALTHCARE, LTD
Entity type:Organization
Organization Name:R & J HEALTHCARE, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRANE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CUPPLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-732-2826
Mailing Address - Street 1:1307 W WASHINGTON ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:OREGON
Mailing Address - State:IL
Mailing Address - Zip Code:61061-1001
Mailing Address - Country:US
Mailing Address - Phone:815-732-2826
Mailing Address - Fax:815-732-7617
Practice Address - Street 1:1307 W WASHINGTON ST
Practice Address - Street 2:SUITE 115
Practice Address - City:OREGON
Practice Address - State:IL
Practice Address - Zip Code:61061-1022
Practice Address - Country:US
Practice Address - Phone:815-732-2826
Practice Address - Fax:815-732-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1205903788Medicare PIN