Individual provider Active NPI

Amy R Hershberger, D.C.

  • Chiropractor
  • Winnebago, IL
National Provider Identifier
1114287877
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012187 Issued in IL
Practice address
506 N Elida St
Suite 2
Winnebago, IL 61088
Phone
(815) 541-7719
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012187 IL Primary

Addresses

Primary practice location

506 N Elida St
Suite 2
Winnebago, IL 61088

Mailing address

506 N Elida St
PO Box 383
Winnebago, IL 61088
Phone (815) 335-1381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012187ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Freedlund Family Chiropratic LTD Chiropractor CurrentSince Dec 6, 2020 Accepting new patients

Locations

506 N Elida St
Winnebago, IL 61088
Phone (815) 222-4596

506 N Elida St
#2
Winnebago, IL 61088
Phone (815) 541-7719

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1114287877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 N ELIDA ST",
            "address_2": "PO BOX 383",
            "city": "WINNEBAGO",
            "state": "IL",
            "postal_code": "61088",
            "telephone_number": "815-335-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 N ELIDA ST",
            "address_2": "SUITE 2",
            "city": "WINNEBAGO",
            "state": "IL",
            "postal_code": "61088",
            "telephone_number": "815-541-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHBERGER",
        "first_name": "AMY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnebago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.