Provider Demographics
NPI:1902930969
Name:FORBES CHIROPRACTIC & REHAB
Entity Type:Organization
Organization Name:FORBES CHIROPRACTIC & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-797-2225
Mailing Address - Street 1:4700 NAMEOKI RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-2524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4700 NAMEOKI RD
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-2524
Practice Address - Country:US
Practice Address - Phone:618-797-2225
Practice Address - Fax:618-797-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00217167OtherPALMETO GBA - RR MEDICARE
IL6007286OtherBLUE CROSS BLUE SHIELD
IL=========OtherCIGNA, UNITED HEALTHCARE
IL6007286OtherBLUE CROSS BLUE SHIELD
ILP00217167OtherPALMETO GBA - RR MEDICARE
IL204779Medicare ID - Type UnspecifiedMEDICARE ILLINOIS WPS