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Organization
CLANAHAN WELLNESS CENTER INC
Active
Organization
CLANAHAN WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD H CLANAHAN DC (PRESIDENT)
(309) 353-3300
Entity
Organization
Contact information
Practice address
105 N PARKWAY DR, PEKIN, IL 61554-3932
(309) 353-3300
(309) 353-7961
Mailing address
105 N PARKWAY DR, PEKIN, IL 61554-3932
(309) 353-3300
(309) 353-7961
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008668
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09022697
BLUE CROSS BLUE SHIELD
IL
01
—
3500559154
RAILROAD MEDICARE
IL
Enumeration date
08/22/2006
Last updated
10/19/2016
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