Organization
KHAIRALLAH CHIROPRACTIC PC
Active
Other names
JSK Chiropractic PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH S KHAIRALLAH D.C. (PRESIDENT)
(309) 679-9575
Entity
Organization
Contact information
Practice address
4501 N STERLING AVE, SUITE 104, PEORIA, IL 61615-3834
(309) 679-9575
Mailing address
4501 N STERLING AVE, SUITE 104, PEORIA, IL 61615-3834
(309) 679-9575
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07232021
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/04/2006
Last updated
08/22/2020
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