Healthcare Provider Details

I. General information

NPI: 1134193022
Provider Name (Legal Business Name): DONALD WILBERT PILLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 LAKEWOOD DR
MENDOTA IL
61342
US

IV. Provider business mailing address

PO BOX 286 1312 LAKEWOOD DR
MENDOTA IL
61342
US

V. Phone/Fax

Practice location:
  • Phone: 815-539-7189
  • Fax: 815-538-2358
Mailing address:
  • Phone: 815-539-7189
  • Fax: 815-538-2358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: