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NPI Code Detail

MEDICARE: WILLS CHIROPRACTIC LLC

MEDICARE: WILLS CHIROPRACTIC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1881004240
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLS CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 102 MAPLE AVE
Second Line :
City : ROCHELLE
State : IL
Zip : 61068-8926
Country : US
Telephone Number : 815-562-5333
Fax Number : 815-562-5833
Provider Business Practice Location Address
First Line : 102 MAPLE AVE
Second Line :
City : ROCHELLE
State : IL
Zip : 61068-8926
Country : US
Telephone Number : 815-562-5333
Fax Number : 815-562-5833
Authorized Official
Title or Position : PROVIDER
Name : DR. STACY FAYE WILLS
Credential : DC
Telephone Number : 815-562-5333
Provider Enumeration Date : 05/06/2014
Last Update Date : 11/10/2014

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Directions to “WILLS CHIROPRACTIC LLC ” Practice Location

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