Gary R. Childs,DC,SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

GARY R. CHILDS,DC,SC

Doing business as

east peoria chiropractic

Practice address

1605 E Washington St
East Peoria, IL 61611-2867

Phone

(309) 698-7010

Fax

(309) 698-7065

NPI assigned

Mar 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary R Childs, DCNPI 1588733711

Title

President

Phone

(309) 698-7010

Specialties & licenses 1

Addresses

Other names 1

• east peoria chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Callen R Childs, DC

  • Chiropractor
  • East Peoria, IL
  • NPI 1073612180
  Medicare reassignment NPD
• Gary R Childs, DC

  • Chiropractor
  • East Peoria, IL
  • NPI 1588733711
  NPD (past) Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144340860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112867",
            "telephone_number": "309-698-7010",
            "fax_number": "309-698-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112867",
            "telephone_number": "309-698-7010",
            "fax_number": "309-698-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY R. CHILDS,DC,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-698-7010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "east peoria chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fondulac Rehabilitation & Health Care Center LLC
• Jennifer Anne Forck
• Fresenius Medical Care East Peoria Home, LLC (Fresenius Kidney Care East Peoria Home)
• Dax Fuiten, PHARM.D
• Michael Norman Gabor, D.D.S.
• Katrina Renee Gelhausen, M.S. CCC/SLP
• Generations at Riverview Senior Living
• Generations at Riverview, LLC
• Jerri Jean Genovese, MSW, LCSW, CADC
• Miranda Gilliam

• 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 Aug 22, 2020; 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.

Verify at the official NPI Registry.