NPIMap

Organization Active NPI

Hulsebus and Gehlsen Chiropractic

  • Chiropractor
  • Freeport, IL
National Provider Identifier
1043433162
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
060005547 Issued in IL
Legal business name
HULSEBUS AND GEHLSEN CHIROPRACTIC
Practice address
630 Terra West Dr
Freeport, IL 61032-4536
Phone
(815) 235-7858
Fax
(815) 235-7913
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Dr. Jeffrey P Gehlsen, D.C.NPI 1750397667
Title
Vice President Director
Phone
(815) 235-7858

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 060005547 IL Primary

Addresses

Primary practice location

630 Terra West Dr
Freeport, IL 61032-4536

Mailing address

630 Terra West Dr
Freeport, IL 61032-4536
Phone (815) 235-7858

Other identifiers 1

IdentifierTypeStateIssuer
210296OtherILMEDICARE P-TAN

Other names 1

  • Hulsebus Chiropractic Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041111000035 IL Part B Supplier - Clinic/Group Practice 1557324415 Receives reassigned benefits from 3 practitioners
Practice locations: Freeport, IL

National Provider Directory

National Provider Directory

Locations

630 Terra West Dr
Freeport, IL 61032
Phone (815) 235-7858

Practitioners & affiliated clinicians

Practitioners 12

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1043433162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TERRA WEST DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324536",
            "telephone_number": "815-235-7858",
            "fax_number": "815-235-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 TERRA WEST DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324536",
            "telephone_number": "815-235-7858",
            "fax_number": "815-235-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HULSEBUS AND GEHLSEN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "GEHLSEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "815-235-7858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "060005547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "210296",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hulsebus Chiropractic Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.