Robert Joseph Brown, D.C.
Individual provider Active NPI Chiropractor · Staunton, IL
NPI 1205940947 · NPPES record last updated Oct 24, 2012
Key facts
- NPI
- 1205940947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038-003458 (IL)
- Practice address
- 704 S Hackman St
Staunton, IL 62088-1630 - Phone
- (618) 635-2502
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051010000403 | IL | Practitioner - Chiropractic | 8325063357 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-003458 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Macoupin County Chiro Partnership | Chiropractor | Current |
Accepting new patients |
| Staunton Chiropractic Clinic, Inc. | Chiropractor | Past |
Accepting new patients |
| North Arkansas Regional Medical Center | Past |
Accepting new patients |
Locations
490 W Side Sq
Carlinville, IL 62626
Phone (217) 854-2557
704 S Hackman St
Staunton, IL 62088
Phone (618) 635-2502
Interoperability endpoints
- mc@mcc0017.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-003458 | IL | Yes |
Addresses
Primary practice location
704 S Hackman St
Staunton, IL 62088-1630
Mailing address
704 S Hackman St
Staunton, IL 62088-1630
Phone (618) 635-2502
Other providers in Staunton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2012. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.