Michael A Wampfler, D.C.
Individual provider Active NPI Chiropractor · Stockton, IL
NPI 1023150992 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023150992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 1615 Summit Dr
Stockton, IL 61085-9126 - Phone
- (815) 947-3320
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1615 Summit Dr
Stockton, IL 61085-9126
Phone (815) 947-3320
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050519000656 | IL | Practitioner - Chiropractic | 2163463365 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-010297 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Chiropractic Rockford | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
1615 Summit Dr
Stockton, IL 61085-9126
Mailing address
1615 Summit Dr
Stockton, IL 61085
Phone (815) 947-2906
Other providers in Stockton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.