Provider Demographics
NPI:1912125626
Name:MOLCK, CHRISTOPHER HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HENRY
Last Name:MOLCK
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 1:2111 129TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:IL
Mailing Address - Zip Code:61264-4997
Mailing Address - Country:US
Mailing Address - Phone:563-289-5145
Mailing Address - Fax:309-794-2156
Practice Address - Street 1:515 VALLEY VIEW DR STE 205
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6175
Practice Address - Country:US
Practice Address - Phone:309-788-8239
Practice Address - Fax:309-794-2156
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010460111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation