Carlinville Chiropractic Clinic LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

37-11104570 Issued in IL

Legal business name

CARLINVILLE CHIROPRACTIC CLINIC LTD

Practice address

295 North Broad
Carlinville, IL 62626-1301

Phone

(217) 854-8211

Fax

(217) 854-3636

NPI assigned

Dec 28, 2007

Last updated

Jun 25, 2013By 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. Mark Walter Wade, DCNPI 1972553410

Title

Chiropractic

Phone

(217) 854-8211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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.

• Mark W. Wade, D.C.

  • Chiropractor
  • Carlinville, IL
  • NPI 1972553410
  Medicare reassignment Authorized official
• Austin Hubbard, D.C

  • Chiropractor
  • Carlinville, IL
  • NPI 1023555166
  Medicare reassignment
• Raymond Krist Atanasoff, OD

  • Optometrist
  • Iron River, MI
  • NPI 1376551788
  NPD (past)

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1174707939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 NORTH BROAD",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-8211",
            "fax_number": "217-854-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 NORTH BROAD",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261301",
            "telephone_number": "217-854-8211",
            "fax_number": "217-854-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLINVILLE CHIROPRACTIC CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CHIROPRACTIC",
        "authorized_official_telephone_number": "217-854-8211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "37-11104570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlinville Area Hospital Association
• Carlinville Area Hospital Association (Carlinville Area Hospital)
• Carlinville Area Hospital Association (Carlinville Area Hospital)
• Carlinville Area Hospital Association (Carlinville Area Hospital)
• Carlinville Area Hospital Association (Carlinville Family Health Care)
• Carlinville Community Unit School District #1
• Carlinville Eye Care PC
• Carlinville Health & Prescription Services (Sullivan Drugs)
• Carlinville Health & Prescriptions Services Inc (Sullivan Drugs of Carlinville)
• Carlinville Medical Clinic, Inc.

• Chiropractor in Carlinville, IL
• Providers in Carlinville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.