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Organization
RICHIE CHIROPRACTIC PC
Active
Organization
RICHIE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOREN WILLIAMS RICHIE DC (PRESIDENT)
(217) 698-1311
Entity
Organization
Contact information
Practice address
2205 WABASH AVE, SUITE 107, SPRINGFIELD, IL 62704-5354
(217) 698-1311
(217) 698-7504
Mailing address
2205 WABASH AVE, SUITE 107, SPRINGFIELD, IL 62704-5354
(217) 698-1311
(217) 698-7504
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008580
IL
225100000X
Physical Therapist
070014190
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008432155
BLUE CROSS BLUE SHIELD
IL
01
—
DF1837
RAILROAD MEDICARE
IL
Enumeration date
08/08/2006
Last updated
06/30/2008
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