Provider Demographics
NPI:1740245349
Name:SPIELMAN, THOMAS ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:SPIELMAN
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 1:3913 15TH STREET D
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265
Mailing Address - Country:US
Mailing Address - Phone:309-797-3513
Mailing Address - Fax:309-797-3795
Practice Address - Street 1:3913 15TH STREET D
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-797-3513
Practice Address - Fax:309-797-3795
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD38003822Medicaid
IL0008182023OtherBLUE CROSS
606920Medicare ID - Type Unspecified
IL0008182023OtherBLUE CROSS