Kevin Daniel Derouen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.014421 Issued in IL

Practice address

404 S Kennedy Dr
Bradley, IL 60915-2137

Phone

(815) 929-9296

NPI assigned

Jan 22, 2026

Last updated

Jan 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Van Til Chiropractic PCGroup PAC ID 6709866296, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Van Til Chiropractic, PC.

  dba Van Til Chiropractic

  • Chiropractor
  • Bradley, IL
  • NPI 1801994470
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1769040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1093674228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S OPPYVILLE RD",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609707911",
            "telephone_number": "757-254-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S KENNEDY DR",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152137",
            "telephone_number": "815-929-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROUEN",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Davault, OT
• Sara Elisabeth Day, DMD
• Rahul Deepankar, MD
• Melissa Rosenow Delioglou, PSYD
• Kyle A Denny, PA-C
• Holly Koren Dinello, NP-C
• Dr.Joseph Mayotte D.C P.C
• Shannon Ducat
• Paula Renee Dykstra, LCSW
• Kaase Gayl El-Talabani

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.