Individual provider Active NPI

Barry Edward Williamson, D.C.

  • Chiropractor
  • Wheaton, IL
National Provider Identifier
1023135985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
400 W Roosevelt Rd
Wheaton, IL 60187-2329
Phone
(630) 682-0575
Fax
(630) 682-0581
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

400 W Roosevelt Rd
Wheaton, IL 60187-2329

Mailing address

400 W Roosevelt Rd
Wheaton, IL 60187-2329
Phone (630) 682-0575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000782 IL Practitioner - Chiropractic 8224102454 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-003694ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
B E Williamson DC PC CurrentSince Jun 14, 1983 Accepting new patients

Locations

100 W Roosevelt Rd
Ste A4-104
Wheaton, IL 60187
Phone (630) 682-0575

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023135985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872329",
            "telephone_number": "630-682-0575",
            "fax_number": "630-682-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872329",
            "telephone_number": "630-682-0575",
            "fax_number": "630-682-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "BARRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.