Healthcare Provider Details

I. General information

NPI: 1184893885
Provider Name (Legal Business Name): PIRIE CHIROPRACTIC CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 ESSINGTON RD
JOLIET IL
60435-2869
US

IV. Provider business mailing address

1011 ESSINGTON RD
JOLIET IL
60435-2869
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-8345
  • Fax: 815-725-8310
Mailing address:
  • Phone: 815-725-8345
  • Fax: 815-725-8310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038009041
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY M PIRIE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 815-725-8345