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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