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Organization
ALLIED PHYSICIANS AND REHAB OF SOUTHERN ILLINOIS, S.C.
Active
Organization
ALLIED PHYSICIANS AND REHAB OF SOUTHERN ILLINOIS, S.C.
Active
Other names
Bird Chiropractic BC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN E BIRD D.C. (OWNER/DOCTOR)
(618) 529-5172
Entity
Organization
Contact information
Practice address
1100 W MAIN ST, CARBONDALE, IL 62901-2335
(618) 529-5172
(618) 529-9152
Mailing address
1100 W MAIN ST, CARBONDALE, IL 62901-2335
(618) 529-5172
(618) 529-9152
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03923662
BLUE CROSS BLUE SHIELD
—
01
—
042618237
MEDICAL LICENSE CORP #
IL
Enumeration date
01/25/2007
Last updated
12/15/2015
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