Provider Demographics
NPI:1487950721
Name:CORRECTIVE CHIROPRACTIC HEALTH CENTER INC
Entity type:Organization
Organization Name:CORRECTIVE CHIROPRACTIC HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUPLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-755-9515
Mailing Address - Street 1:2500 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-2619
Mailing Address - Country:US
Mailing Address - Phone:309-755-9515
Mailing Address - Fax:309-755-9521
Practice Address - Street 1:2500 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-2619
Practice Address - Country:US
Practice Address - Phone:309-755-9515
Practice Address - Fax:309-755-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty