Organization Active NPI

Willareth Clinic of Chiropractic LTD.

  • Chiropractor
  • Morris, IL
National Provider Identifier
1013210152
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC38-3315 Issued in IL
Legal business name
WILLARETH CLINIC OF CHIROPRACTIC LTD.
Practice address
118 E. Jackson St
Morris, IL 60450-1891
Phone
(815) 942-5350
Fax
(815) 942-5414
NPI assigned
Dec 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Dr. Glenn C Willareth, DC
Title
Pres
Phone
(815) 942-5350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC38-3315 IL Primary

Addresses

Primary practice location

118 E. Jackson St
Morris, IL 60450-1891

Mailing address

118 E. Jackson St
Morris, IL 60450-1891
Phone (815) 942-5350

National Provider Directory

National Provider Directory

Locations

118 E Jackson St
Morris, IL 60450
Phone (815) 791-4089

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1013210152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E. JACKSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501891",
            "telephone_number": "815-942-5350",
            "fax_number": "815-942-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E. JACKSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501891",
            "telephone_number": "815-942-5350",
            "fax_number": "815-942-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLARETH CLINIC OF CHIROPRACTIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "WILLARETH",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "815-942-5350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "DC38-3315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.