Shannon L Chidlow, DC
Individual provider Active NPI Chiropractor · Steger, IL
NPI 1245266287 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245266287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 22 E 33Rd PL
Steger, IL 60475-1181 - Phone
- (708) 754-0777
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Interoperability endpoints
- shannon.chidlow@25253780.chartlogic.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
22 E 33Rd PL
Steger, IL 60475-1181
Mailing address
3626 Green St
Steger, IL 60475-1628
Phone (708) 754-0777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9928211 | Other | IL | BLUECROSS BLUESHIELD |
Other providers in Steger, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.