Provider Demographics
NPI:1922180975
Name:CROTHERS, ROBERT ALLAN (DC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLAN
Last Name:CROTHERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W PINE ST
Mailing Address - Street 2:STE 2
Mailing Address - City:CHILLICOTHE
Mailing Address - State:IL
Mailing Address - Zip Code:61523-1849
Mailing Address - Country:US
Mailing Address - Phone:309-274-9400
Mailing Address - Fax:309-274-9430
Practice Address - Street 1:300 W PINE ST
Practice Address - Street 2:STE 2
Practice Address - City:CHILLICOTHE
Practice Address - State:IL
Practice Address - Zip Code:61523-1849
Practice Address - Country:US
Practice Address - Phone:309-274-9400
Practice Address - Fax:309-274-9430
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor