Provider Demographics
NPI:1053524157
Name:PARTNERS IN HEALTH OF THE ROCK RIVER VALLEY SC
Entity type:Organization
Organization Name:PARTNERS IN HEALTH OF THE ROCK RIVER VALLEY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BOERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-626-0212
Mailing Address - Street 1:2605 WOODLAWN RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-4174
Mailing Address - Country:US
Mailing Address - Phone:815-626-0212
Mailing Address - Fax:815-622-3267
Practice Address - Street 1:2605 WOODLAWN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-4174
Practice Address - Country:US
Practice Address - Phone:815-626-0212
Practice Address - Fax:815-622-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty