Weiss Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WEISS CHIROPRACTIC CENTER

Practice address

409 E Front St
Bloomington, IL 61701-5309

Phone

(309) 828-3415

Fax

(309) 828-2665

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mary L. Beach, D.C.NPI 1013009083

Title

Chiropractic Physician/Owner

Phone

(309) 828-3415

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Mary Lou Beach, D.C., C.C.S.P.

  • Sports Physician Chiropractor
  • Bloomington, IL
  • NPI 1013009083
  NPD (past) Authorized official
• Stephen Mark Weiss, D.C.

  • Chiropractor
  • Bloomington, IL
  • NPI 1407956626
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1174712061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E FRONT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015309",
            "telephone_number": "309-828-3415",
            "fax_number": "309-828-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E FRONT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015309",
            "telephone_number": "309-828-3415",
            "fax_number": "309-828-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEISS CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "BEACH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "309-828-3415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5782017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaime Lee Weddingfeld, PHARMD
• Amanda Lyn Weed, APN
• Sheyanne Weed
• Elizabeth L Weinzierl
• Barbara Luann Weis, FNP BC
• Weiss Wellness & Chiropractic, LTD.
• Stephen Mark Weiss, D.C.
• Shari Joy Weitekamp, MA, CCC-SLP L
• Kassidy Weller, OTR/L
• Richard W Wellman, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.