Provider Demographics
NPI:1316950827
Name:DARDING CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:DARDING CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DARDING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-939-9969
Mailing Address - Street 1:1327 JAMIE LN
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298-5569
Mailing Address - Country:US
Mailing Address - Phone:618-939-9969
Mailing Address - Fax:618-939-9978
Practice Address - Street 1:1327 JAMIE LN
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-5569
Practice Address - Country:US
Practice Address - Phone:618-939-9969
Practice Address - Fax:618-939-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDC1878Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP
IL209254Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER