Active NPI
Kenneth Kruchten, DC
- Sports Physician Chiropractor
- Watseka, IL
National Provider Identifier
1124210489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 038005663
- Legal business name
- KENNETH KRUCHTEN, DC
- Practice address
- 209 S 5TH St
Watseka, IL 60970-1659 - Phone
- (815) 432-6201
- Fax
- (815) 432-5416
- NPI assigned
- Aug 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth Kruchten, DC
- Title
- Owner
- Phone
- (815) 432-6201
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 038005663 | IL | Primary |
Addresses
Primary practice location
209 S 5TH St
Watseka, IL 60970-1659
Mailing address
209 S 5TH St
Watseka, IL 60970-1659
Phone (815) 432-6201
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9982032 | Other | BLUE CROSS BLUE SHIELD | |
| 038005663 | Medicaid | IL |
National Provider Directory
National Provider Directory- Tax ID family
- Kenneth Kruchten DC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- Crest Hill, IL
- NPI 1003299579
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sports Physician Chiropractor
- Crest Hill, IL
- NPI 1730216532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209945600000",
"number": "1124210489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 S 5TH ST",
"city": "WATSEKA",
"state": "IL",
"postal_code": "609701659",
"telephone_number": "815-432-6201",
"fax_number": "815-432-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 S 5TH ST",
"city": "WATSEKA",
"state": "IL",
"postal_code": "609701659",
"telephone_number": "815-432-6201",
"fax_number": "815-432-5416"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENNETH KRUCHTEN, DC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-10",
"last_updated": "2008-05-05",
"status": "A",
"authorized_official_last_name": "KRUCHTEN",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-432-6201",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Sports Physician",
"state": "IL",
"license": "038005663",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "9982032",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038005663",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watseka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.