Talley, Jason R

Talley, Jason R is an individual health care provider with primary practice located at 2025 Edison Ave , Granite City IL 62040-4514. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Talley, Jason R can be contacted via phone (618) 451-2874.

Contact Information

Primary practice address
2025 Edison Ave Granite City IL 62040-4514
Phone: (618) 451-2874
Fax: (618) 451-2858
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038-009072 Illinois

Profile Details

NPI number 1144224734
LBN Legal business name Talley, Jason R
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Dec 4th, 2019 - about 5 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 1144224734 NPPES
Illinois Other 4400069 UNITED HEALTH CARE
Illinois Other 442971 UNITED HEALTH CARE
Illinois Other 350054835 UNITED HEALTH CARE
Illinois Other 6026195 UNITED HEALTH CARE
Illinois Other U81510 UNITED HEALTH CARE
Illinois MEDICAID 038009072 UNITED HEALTH CARE

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