Shawni Lyn Groezinger, DC
Individual provider Active NPI Chiropractor · Lanark, IL
NPI 1295749448 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295749448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0038-008397 (IL)
- Practice address
- 502 Il Route 64
Lanark, IL 61046-8904 - Phone
- (815) 493-2666
- NPI assigned
- Jul 27, 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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0038-008397 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0038-008397 | IL | Yes |
Addresses
Primary practice location
502 Il Route 64
Lanark, IL 61046-8904
Mailing address
502 Il Route 64
Lanark, IL 61046-8904
Phone (815) 493-2666
Other providers in Lanark, 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.