Provider Demographics
NPI:1174165773
Name:STANFIELD CHIROPRACTIC OF EFFINGHAM LLC
Entity type:Organization
Organization Name:STANFIELD CHIROPRACTIC OF EFFINGHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-342-7222
Mailing Address - Street 1:414 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2336
Mailing Address - Country:US
Mailing Address - Phone:217-342-7222
Mailing Address - Fax:217-342-7214
Practice Address - Street 1:414 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2336
Practice Address - Country:US
Practice Address - Phone:217-342-7222
Practice Address - Fax:217-342-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty