Healthcare Provider Details

I. General information

NPI: 1932256112
Provider Name (Legal Business Name): MICHAEL Z BIALAS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 COLUMBIA RD
DUPO IL
62239-1429
US

IV. Provider business mailing address

1421 COLUMBIA RD
DUPO IL
62239-1429
US

V. Phone/Fax

Practice location:
  • Phone: 618-799-8752
  • Fax: 618-286-6507
Mailing address:
  • Phone: 618-799-8752
  • Fax: 618-286-6507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2001023792
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2001023792
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2001023792
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: