IndividualActive
Mary Beach, D.C., C.C.S.P.
NPI 1013009083 · Sports Physician Chiropractor · Bloomington, IL
Provider details
- NPI number
- 1013009083
- Entity type
- Individual
- Primary specialty
- Sports Physician ChiropractorChiropractic Providers
- Credential
- D.C., C.C.S.P.
- Sex
- Female
- Sole proprietor
- No
- License
- 038-005425 (IL)
Specialties & taxonomies
Chiropractic Providers
Practice location
409 E Front St
Bloomington, IL 61701-5309
Phone: (309) 828-3415
Fax: (309) 828-2665
Approximate (ZIP-level) locationGet directions
Mailing address
409 E Front St
Bloomington, IL 61701-5309
Registry dates
- Enumerated
- 2006-09-28
- Last updated
- 2011-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.