Central Illinois Chiropractic Center PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.011847 Issued in IL

Legal business name

CENTRAL ILLINOIS CHIROPRACTIC CENTER PC

Practice address

731 Sabrina Dr Unit B
East Peoria, IL 61611-3582

Phone

(309) 699-2422

NPI assigned

Sep 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Michael Walz, DCNPI 1841594850

Title

Owner

Phone

(309) 699-2422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Christopher Walz, D.C.

  • Chiropractor
  • East Peoria, IL
  • NPI 1841594850
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1164941308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 SABRINA DR UNIT B",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616113582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 SABRINA DR UNIT B",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616113582",
            "telephone_number": "309-699-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Eastland Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617047923",
            "country_code": "US",
            "telephone_number": "309-808-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WALZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-699-2422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Buster, M.S.
• Aneta M Byrd, LPN
• Kelsey Elizabeth Casolari, APRN
• Central Illinois Center for TMJ and Facial Pain PC
• Central Illinois Center for TMJ and Facial Pain, P.C.
• Erin Chan
• Chicago Hearing LLC
• Callen R Childs, DC
• Gary R Childs, DC
• Seo Woo Choi, DDS

• 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 Mar 17, 2018; 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.