Dr. Mary Lou Beach
Chiropractic Sports Physician
409 E Front St
Bloomington
, Illinois 61701-5309
Dr. Mary Lou Beach
Chiropractic Sports Physician
409 E Front St
Bloomington
, Illinois 61701-5309
(309) 828-2665
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Mary Lou Beach
- 409 E Front St
- Bloomington, IL
- Zip : 61701-5309
- Fax : (309) 828-2665
- Phone : (309) 828-3415
Second Address
- Dr. Mary Lou Beach
- 409 E Front St
- Bloomington, IL
- Zip : 61701-5309
- Fax : (309) 828-2665
- Phone : (309) 828-3415
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | 038-005425 | IL |
National Provider Identifier
| NPI | 1013009083 |
|---|---|
| Provider Name | Dr. Mary Lou Beach |
| First Address | Bloomington, IL 61701-5309 |
| Second Address | Bloomington, IL 61701-5309 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/09/2006 |
| Last Update Date | 28/09/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T38488 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.