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SOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC
NPI 1053664557
Chiropractor in Marissa, IL

Active since October 22, 2012
112 N MAIN ST, MARISSA, IL 62257(618) 295-2268(618) 295-3521 Get Directions Write a Review

NPPES record last updated: December 12, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Illinois Spine & Joint Center Of Marissa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC (NPI 1053664557) is a healthcare organization registered as a chiropractor in Marissa, Illinois and active in the NPI registry since October 2012. The organization lists Ryan Reiss, Manager, as its authorized official.

NPPES Registry Identity

NPI1053664557
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameSOUTHERN ILLINOIS SPINE & JOINT CENTER OF MARISSA LLC
Location Address112 N MAIN STMarissa, IL 62257-1365
Mailing Address112 N Main StMarissa, IL 62257-1365 · (618) 295-2268 · Fax (618) 295-3521
Phone(618) 295-2268
Fax(618) 295-3521
Organization SubpartNo
Authorized OfficialRyan ReissManager · (618) 443-2026
Enumeration DateOctober 22, 2012
Last NPPES UpdateDecember 12, 2012
✔ NPI 1053664557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038011854
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
112 N MAIN ST, Marissa, IL 62257
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GARY LANE BENEDICT D.C.
Chiropractor
112 N MAIN ST
MARISSA, IL 62257
St. Clair County (618) 295-2268
SOUTHERN ILLINOIS SPINE & JOINT CENTER
Chiropractor
112 N MAIN ST
MARISSA, IL 62257
St. Clair County (618) 295-2268
DR. DILLON LEE KAESBERG D.C.
Chiropractor
112 N MAIN ST
MARISSA, IL 62257
St. Clair County (618) 295-2268

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois Spine & Joint Center Of Marissa LLC's NPI number?

The NPI number for Southern Illinois Spine & Joint Center Of Marissa LLC is 1053664557. It was assigned to this organization in the NPPES registry on October 22, 2012.

Where is Southern Illinois Spine & Joint Center Of Marissa LLC located?

Southern Illinois Spine & Joint Center Of Marissa LLC is located at 112 N Main St, Marissa, IL 62257. The listed phone number is (618) 295-2268.

What is Southern Illinois Spine & Joint Center Of Marissa LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Southern Illinois Spine & Joint Center Of Marissa LLC was last updated on December 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.