Organization Active NPI

Patrick B. Whitaker, D.C., P.C.

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1104190503
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PATRICK B. WHITAKER, D.C., P.C.
Practice address
129 Phelps Ave
Suite 316
Rockford, IL 61108-2453
Phone
(815) 229-5568
Fax
(815) 229-0942
NPI assigned
Mar 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Authorized official

Name
Dr. Patrick B Whitaker, D.C.
Title
Owner
Phone
(815) 229-5568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

129 Phelps Ave
Suite 316
Rockford, IL 61108-2453

Mailing address

129 Phelps Ave
Suite 316
Rockford, IL 61108-2453
Phone (815) 229-5568

Other identifiers 1

IdentifierTypeStateIssuer
T37426OtherILUPIN

National Provider Directory

National Provider Directory

Locations

129 Phelps Ave
Ste 316
Rockford, IL 61108
Phone (815) 229-5568

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330646400000",
    "number": "1104190503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 PHELPS AVE",
            "address_2": "SUITE 316",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082453",
            "telephone_number": "815-229-5568",
            "fax_number": "815-229-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 PHELPS AVE",
            "address_2": "SUITE 316",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082453",
            "telephone_number": "815-229-5568",
            "fax_number": "815-229-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK B. WHITAKER, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-229-5568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T37426",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.