Functional Regenerative Services of Illinois LTD LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FUNCTIONAL REGENERATIVE SERVICES OF ILLINOIS LTD LLC

Practice address

902 S Court Street
Suite 2
Tuscola, IL 61953

Phone

(217) 253-2370

NPI assigned

Apr 14, 2021

Last updated

Jun 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristina Nicole Smith, APRN-FNP-C

Title

Nurse Practitioner

Phone

(217) 253-2370

Specialties & licenses 1

Addresses

Tax ID family

Functional Regenerative Services of Illinois LTD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tuscola Pain & Wellness Center SC

  • Chiropractor
  • Tuscola, IL
  • NPI 1396856688
  NPD tax ID

Locations

Practitioners 1

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.

• William G Hemmer, DC

  • Chiropractor
  • Tuscola, IL
  • NPI 1164611786
  NPD (past)

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1043891880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S COURT STREET",
            "address_2": "SUITE 2",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "61953",
            "telephone_number": "217-253-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S COURT STREET",
            "address_2": "SUITE 2",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "61953",
            "telephone_number": "217-253-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL REGENERATIVE SERVICES OF ILLINOIS LTD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "217-253-2370",
        "authorized_official_credential": "APRN-FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas County Mental Health and Family Counseling Association Inc. (RISE Behavioral Health and Wellness)
• Douglas County Mental Health and Family Counseling Association Inc. (RISE Behavioral Health and Wellness)
• M'Lissa Ann Duncan, MSMCT, RN, HNB-BC
• Jacy Ann Durdel
• First Step Home Sleep Testing Inc.
• George a. Rotramel DMD LTD
• Haven of Tuscola, LLC
• Kaci Helfrich, APRN
• William G Hemmer, DC
• Casey R Hoenes, NP

• Family Nurse Practitioner in Tuscola, IL
• Providers in Tuscola, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.