Performance Chiropractic and Sports Rehabilitation, LLC.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038013077 Issued in IL

Legal business name

PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION, LLC.

Practice address

122 S 2ND St
Greenville, IL 62246-1723

Phone

(618) 690-5100

Fax

(618) 690-5101

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Neil Leon Micnheimer, D.C.

Title

Sole Owner

Phone

(618) 690-5100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1053850990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S 6TH ST",
            "city": "NEW DOUGLAS",
            "state": "IL",
            "postal_code": "620741622",
            "telephone_number": "618-690-5100",
            "fax_number": "618-690-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S 2ND ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461723",
            "telephone_number": "618-690-5100",
            "fax_number": "618-690-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "MICNHEIMER",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "618-690-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Greenville, IL
• Providers in Greenville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.