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SOUTHERN ILLINOIS SPORT AND SPINE LLC
NPI 1215277967
Chiropractor in Benton, IL

Active since February 17, 2013
106 W WASHINGTON ST, BENTON, IL 62812(618) 435-3888 Get Directions Write a Review

NPPES record last updated: May 7, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southern Illinois Sport And Spine Llc NPPES

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

SOUTHERN ILLINOIS SPORT AND SPINE LLC (NPI 1215277967) is a healthcare organization registered as a chiropractor in Benton, Illinois and active in the NPI registry since February 2013. The organization lists Luke William Koehn, Chiropractor, as its authorized official.

NPPES Registry Identity

NPI1215277967
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameSOUTHERN ILLINOIS SPORT AND SPINE LLC
Location Address106 W WASHINGTON STBenton, IL 62812-1337
Mailing Address106 W Washington StBenton, IL 62812-1337 · (618) 435-3888
Phone(618) 435-3888
Organization SubpartNo
Authorized OfficialLuke William KoehnChiropractor · (618) 521-0552
Enumeration DateFebruary 17, 2013
Last NPPES UpdateMay 7, 2013
✔ NPI 1215277967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038012350
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.

106 W WASHINGTON ST, Benton, IL 62812
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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

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

DR. LUKE WILLIAM KOEHN D.C.
Chiropractor
106 W WASHINGTON ST
BENTON, IL 62812
Franklin County (618) 435-3888

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 Sport And Spine LLC's NPI number?

The NPI number for Southern Illinois Sport And Spine LLC is 1215277967. It was assigned to this organization in the NPPES registry on February 17, 2013.

Where is Southern Illinois Sport And Spine LLC located?

Southern Illinois Sport And Spine LLC is located at 106 W Washington St, Benton, IL 62812. The listed phone number is (618) 435-3888.

What is Southern Illinois Sport And Spine 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 Sport And Spine LLC was last updated on May 7, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.