Organization Active NPI

Montgomery Chiropractic Clinic PC

  • Chiropractor
  • Montgomery, IL
National Provider Identifier
1215112446
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MONTGOMERY CHIROPRACTIC CLINIC PC
Practice address
212 Webster Street
Montgomery, IL 60538-1324
Phone
(630) 896-1919
Fax
(630) 896-1233
NPI assigned
Jan 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Dr. Neil Stewart Schlupp, DC
Title
Owner President
Phone
(630) 896-1919

Specialties & licenses 1

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

Addresses

Primary practice location

212 Webster Street
Montgomery, IL 60538-1324

Mailing address

212 Webster Street
Montgomery, IL 60538-1324
Phone (630) 896-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100205000491 IL Part B Supplier - Clinic/Group Practice 8426191925 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, IL

National Provider Directory

National Provider Directory

Locations

212 Webster St
Montgomery, IL 60538
Phone (630) 896-1919

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1215112446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 WEBSTER STREET",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381324",
            "telephone_number": "630-896-1919",
            "fax_number": "630-896-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 WEBSTER STREET",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381324",
            "telephone_number": "630-896-1919",
            "fax_number": "630-896-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "SCHLUPP",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "630-896-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.