MEDICARE: CHIROPRO OF LAKE ST. LOUIS, 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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1922630714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRO OF LAKE ST. LOUIS, LLC

Provider Business Mailing Address
First Line	:	1231 THOUVENOT LN STE 100
Second Line	:
City	:	SHILOH
State	:	IL
Zip	:	62269-7203
Country	:	US
Telephone Number	:	618-234-8300
Fax Number	:	618-234-8295

Provider Business Practice Location Address
First Line	:	6257 RONALD REAGAN DR
Second Line	:
City	:	LAKE ST LOUIS
State	:	MO
Zip	:	63367-2665
Country	:	US
Telephone Number	:	636-442-0607
Fax Number	:	636-625-2330

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT RICE
Credential	:	DC
Telephone Number	:	618-979-0398

Provider Enumeration Date	:	02/10/2020
Last Update Date	:	02/10/2020

Similar Medicare Providers

1699719971 — MS. NANCY S GIAIMO FNP
Practice Location Address:

6261 RONALD REAGAN DR STE B18
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

1770596983 — DR. SCOTT K ROOS MD
Practice Location Address:

6261 RONALD REAGAN DR , STE B19
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax: 636-561-3022

1326387887 — LISA A SCOTT NP-C
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE SAINT LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax: 636-561-3022

1881020006 — DR. RYAN MICHAEL FAULKNER D.C.
Practice Location Address:

6251 RONALD REAGAN DR
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-614-2139
Practice Fax:

1881124311 — CHRISTINA MICHELLE THOMA MD
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

1649777848 — AMANDA GONZALES FNP-BC
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE SAINT LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax: 636-561-3022

1205302460 — ADAM LEE TRIMPE FNP-C
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE SAINT LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

Directions to “CHIROPRO OF LAKE ST. LOUIS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.