Tazewell Physical Medicine SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010333 Issued in IL

Legal business name

TAZEWELL PHYSICAL MEDICINE SC

Practice address

1100 E Washington St
East Peoria, IL 61611-2786

Phone

(309) 698-2500

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William Gregory Weinman, D.C.

Title

Treasurer

Phone

(309) 369-0434

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1124138003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112786",
            "telephone_number": "309-698-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAZEWELL PHYSICAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "WEINMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "309-369-0434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacque Lynn Sutton
• Kelcy Irene Suydam, MS
• Synergy Healthcare Physical Medicine
• Synergy Healthcare Physical Medicine SC
• Tazewell County Resource Centers Inc
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.
• The Loft Rehabilitation of East Peoria LLC
• Thomas R. Nalepka D.D.S

• Chiropractor in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.