Organization Active NPI

Healthy Living Family Chiropractic, P.C.

  • Chiropractor
  • Bloomington, IL
National Provider Identifier
1033350657
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HEALTHY LIVING FAMILY CHIROPRACTIC, P.C.
Practice address
2202 Eastland Dr
Suite B
Bloomington, IL 61704-3585
Phone
(309) 662-3600
NPI assigned
Mar 11, 2009
Last updated
Mar 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
Dr. Chad Christian Wyatt, D.C.NPI 1326287939
Title
President
Phone
(870) 822-0218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2202 Eastland Dr
Suite B
Bloomington, IL 61704-3585

Mailing address

2202 Eastland Dr
Suite B
Bloomington, IL 61704-3585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090423000366 IL Part B Supplier - Clinic/Group Practice 0345398780 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, IL

National Provider Directory

National Provider Directory

Locations

2202 Eastland Dr
Ste B
Bloomington, IL 61704
Phone (309) 661-4657

2206 Eastland Dr
Ste 403
Bloomington, IL 61704

425 W Front St
El Paso, IL 61738
Phone (309) 527-2840

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1033350657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 EASTLAND DR",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EASTLAND DR",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043585",
            "telephone_number": "309-662-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-822-0218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.