Street Chiropractic Associates, CTD.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

060-003323 Issued in IL

Legal business name

STREET CHIROPRACTIC ASSOCIATES, CTD.

Practice address

400 S West St
Olney, IL 62450-1217

Phone

(618) 395-3162

Fax

(618) 395-8111

NPI assigned

Apr 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary Roe Street, D.C.

Title

President

Phone

(618) 395-3800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1023232584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S WEST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501217",
            "telephone_number": "618-395-3162",
            "fax_number": "618-395-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S WEST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501217",
            "telephone_number": "618-395-3162",
            "fax_number": "618-395-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREET CHIROPRACTIC ASSOCIATES, CTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ROE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-395-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "060-003323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan A Stevens
• Sarah K Stevens, M.S., CCC/SLP, DT
• Kathy Stokes
• Deirdre Stout, RN,BS
• Julia Ann Stover
• Robin Stumborg, AS
• Timothy John Sullens
• Arcot D Suresh, MD
• Paul W Sutherland, MD
• Heather E Tait

• Chiropractor in Olney, IL
• Providers in Olney, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.