Active NPI
Jennifer Dianne Illes, D.C., D.AP.
- Chiropractor
- Buffalo, NY
National Provider Identifier
1134436702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X012457-1
- Practice address
- 2900 Main St
Buffalo, NY 14214-1718 - Phone
- (716) 923-4375
- NPI assigned
- Sep 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X012457-1 | NY | Primary |
Addresses
Primary practice location
2900 Main St
Buffalo, NY 14214-1718
Mailing address
2900 Main St
Buffalo, NY 14214-1718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X012457-1 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kruse Chiropractic Corp. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Independent Medical Examiner Chiropractor
- West Palm Beach, FL
- NPI 1487110995
-
- Chiropractor
- Jensen Beach, FL
- NPI 1518510536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1134436702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142141718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142141718",
"telephone_number": "716-923-4375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILLES",
"first_name": "JENNIFER",
"middle_name": "DIANNE",
"name_prefix": "Dr.",
"credential": "D.C., D.AP.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-02",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X012457-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.