Provider Demographics
NPI:1659492775
Name:RICE ENTERPRISES LLC
Entity type:Organization
Organization Name:RICE ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEERHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-756-8691
Mailing Address - Street 1:229 E HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2403
Mailing Address - Country:US
Mailing Address - Phone:815-756-8691
Mailing Address - Fax:
Practice Address - Street 1:229 E HILLCREST DR
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2403
Practice Address - Country:US
Practice Address - Phone:815-756-8691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
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
IL203954Medicare ID - Type UnspecifiedMEDICARE PRACTICE ID