Jeramy David Blackwood, D.C.
Individual provider Active NPI Chiropractor · Milan, IL
NPI 1174852016 · NPPES record last updated Jul 28, 2025
Key facts
- NPI
- 1174852016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038.011293 (IL)
- Practice address
- 222 10TH Ave E
Milan, IL 61264-3120 - Phone
- (309) 520-0222
- Fax
- (309) 786-0797
- NPI assigned
- Dec 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
222 10TH Ave E
Milan, IL 61264-3120
Phone (309) 520-0222
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110316000240 | IL | Practitioner - Chiropractic | 9931381738 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blackwood Chiropractic, PLLC | Chiropractor | Current |
Accepting new patients |
| Lundgren Chiropractic, LTD | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.011293 | IL | Yes |
Addresses
Primary practice location
222 10TH Ave E
Milan, IL 61264-3120
Mailing address
222 10TH Ave E
Milan, IL 61264-3120
Phone (309) 520-0222
Other providers in Milan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.