Todd H Clanahan, DC
Individual provider Active NPI Chiropractor · Pekin, IL
NPI 1992713101 · NPPES record last updated Oct 19, 2016
Key facts
- NPI
- 1992713101
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038008668 (IL)
- Practice address
- 105 N Parkway Dr
Pekin, IL 61554-3932 - Phone
- (309) 353-3300
- Fax
- (309) 353-7961
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|
| 038008668 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038008668 | IL | Yes |
Addresses
Primary practice location
105 N Parkway Dr
Pekin, IL 61554-3932
Mailing address
105 N Parkway Dr
Pekin, IL 61554-3932
Phone (309) 353-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09022697 | Other | IL | BLUE CROSS BLUE SHIELD |
| 3500559154 | Other | IL | RAILROAD MEDICARE |
Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2016. 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.