Organization Active NPI

Chiropracticworksllc

  • Chiropractor
  • Collinsville, IL
National Provider Identifier
1215100227
Registry record updated Jul 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTICWORKSLLC
Practice address
410 Regency Ctr
Collinsville, IL 62234-4659
Phone
(618) 343-3602
NPI assigned
Apr 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2008

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

Authorized official

Name
Dr. Kristopher Michael McClusky, DC
Title
Owner
Phone
(618) 343-3602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

410 Regency Ctr
Collinsville, IL 62234-4659

Mailing address

410 Regency Ctr
Collinsville, IL 62234-4659
Phone (618) 343-3602

Other identifiers 1

IdentifierTypeStateIssuer
06032272OtherILBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217030400000",
    "number": "1215100227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 REGENCY CTR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344659",
            "telephone_number": "618-343-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 REGENCY CTR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344659",
            "telephone_number": "618-343-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTICWORKSLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-07-26",
        "status": "A",
        "authorized_official_last_name": "MCCLUSKY",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-343-3602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "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": "06032272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2008; 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.