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Organization

MAIN STREET CHIROPRACTIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SCOTT DAVID STUCK D.C. (OWNER)
(815) 230-9070
Entity
Organization

Contact information

Practice address
23915 W MAIN ST, SUITE D, PLAINFIELD, IL 60544-1967
(815) 230-9070
(815) 230-9334
Mailing address
23915 W MAIN ST, SUITE D, PLAINFIELD, IL 60544-1967
(815) 230-9070
(815) 230-9334

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9932028
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/13/2007
Last updated
08/22/2020
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