Rout, Pamela J

Rout, Pamela J is an sole proprietor health care provider with primary practice located at 701 E Hanover St , New Baden IL 62265-1908. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Rout, Pamela J can be contacted via phone (618) 588-4976.

Contact Information

Primary practice address
701 E Hanover St New Baden IL 62265-1908
Phone: (618) 588-4976
Fax: (618) 588-4926
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038-004884 Illinois

Profile Details

NPI number 1417953613
LBN Legal business name Rout, Pamela J
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2005
Last updated Jun 25th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417953613 NPPES
Illinois Other 01482003 BCBS
Illinois MEDICAID 038004884 BCBS

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