Southern Illinois Spine & Joint Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010604 Issued in IL

Legal business name

SOUTHERN ILLINOIS SPINE & JOINT CENTER, LLC

Practice address

202 W Jackson St
Suite a
Sparta, IL 62286-1676

Phone

(618) 443-2026

NPI assigned

Oct 18, 2006

Last updated

Aug 17, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ryan Robert Reiss, D.C.NPI 1144324377

Title

Chiropractor

Phone

(618) 443-2026

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Robert Reiss, DC

  • Chiropractor
  • Sparta, IL
  • NPI 1144324377
  Medicare reassignment NPD Authorized official
• Gary Lane Benedict, D.C.

  • Chiropractor
  • Marissa, IL
  • NPI 1235261066
  NPD
• Dillon Lee Kaesberg, D.C.

  • Chiropractor
  • Marissa, IL
  • NPI 1821392952
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1013098854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W JACKSON ST",
            "address_2": "SUITE A",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861676",
            "telephone_number": "618-443-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W JACKSON ST",
            "address_2": "SUITE A",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861676",
            "telephone_number": "618-443-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS SPINE & JOINT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "REISS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "618-443-2026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Jean Sauzek, PHARM.D.
• Rikki Schaefer, PA
• Scott David Schneid, O.D.
• Danielle Scott, PA-C
• Southern Illinois Eyecare PLLC (Southern Illinois Eye Care)
• Sparta Community Hospital
• Sparta Community Hospital (At-Home Health Care)
• Sparta Community Hospital
• Sparta Community Hospital D/B/a Quality Healthcare Clinics
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

• Chiropractor in Sparta, IL
• Providers in Sparta, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.