Individual provider Active NPI

Susan Marie Minder, D.C.

  • Chiropractor
  • Springfield, IL
National Provider Identifier
1124236989
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
2025 W Iles Ave
Suite B
Springfield, IL 62704-4190
Phone
(217) 241-5300
Fax
(217) 241-5322
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary
Rehabilitation Chiropractor 111NR0400X IL

Addresses

Primary practice location

2025 W Iles Ave
Suite B
Springfield, IL 62704-4190

Mailing address

2025 W Iles Ave
Suite B
Springfield, IL 62704-4190
Phone (217) 241-5300

Other identifiers 2

IdentifierTypeStateIssuer
84-20187OtherBLUE CROSS & BLUE SHIELD
339643OtherHEALTH LINK

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
038-008238ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1124236989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 W ILES AVE",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044190",
            "telephone_number": "217-241-5300",
            "fax_number": "217-241-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W ILES AVE",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044190",
            "telephone_number": "217-241-5300",
            "fax_number": "217-241-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "84-20187",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "339643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.