Lori Rynke, D.C.
Individual provider Active NPI Chiropractor · Peru, IL
NPI 1669596011 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669596011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038-006927 (IL)
- Practice address
- 2415 2ND St
Peru, IL 61354-3101 - Phone
- (815) 224-3445
- NPI assigned
- Mar 19, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-006927 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-006927 | IL | Yes |
Addresses
Primary practice location
2415 2ND St
Peru, IL 61354-3101
Mailing address
2415 2ND St
Peru, IL 61354-3101
Phone (815) 224-3872
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5022652 | Other | IL | BCBS# |
Other providers in Peru, 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.