Organization
CHEELY CHIROPRACTIC CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L CHEELY DC (OWNER)
(618) 259-3333
Entity
Organization
Contact information
Practice address
131 N BELLWOOD DR, SUITE D, EAST ALTON, IL 62024-2088
(618) 259-3333
(618) 259-3334
Mailing address
131 N BELLWOOD DR, SUITE D, EAST ALTON, IL 62024-2088
(618) 259-3333
(618) 259-3334
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
042 007970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346314333
INDIVIDUAL NPI
IL
01
—
350053197
RR MEDICARE
IL
01
—
6082035
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/13/2007
Last updated
10/15/2008
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