Provider Demographics
NPI:1528059151
Name:WOODROW, SHEILA J (DC)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:J
Last Name:WOODROW
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 1:1200 E PERSHING RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4729
Mailing Address - Country:US
Mailing Address - Phone:217-875-3010
Mailing Address - Fax:217-875-9071
Practice Address - Street 1:1200 E PERSHING RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4729
Practice Address - Country:US
Practice Address - Phone:217-875-3010
Practice Address - Fax:217-875-9071
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL005815223OtherBCBS OF IL
ILT90314Medicare UPIN
IL914170Medicare ID - Type Unspecified