Provider Demographics
NPI:1194047324
Name:KHOURI, TONYA ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:ELIZABETH
Last Name:KHOURI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-1976
Mailing Address - Country:US
Mailing Address - Phone:309-291-3150
Mailing Address - Fax:
Practice Address - Street 1:330 S MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-1977
Practice Address - Country:US
Practice Address - Phone:093-291-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor