Individual provider Active NPI

Julie Suzanne Teel, DC

  • Chiropractor
  • Benton, IL
National Provider Identifier
1265533418
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009609 Issued in IL
Practice address
509 W Main Street
Benton, IL 62812-1328
Phone
(618) 439-7171
Fax
(618) 439-6151
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009609 IL Primary

Addresses

Primary practice location

509 W Main Street
Benton, IL 62812-1328

Mailing address

509 W Main Street
Benton, IL 62812-1328
Phone (618) 439-7171

Other identifiers 4

IdentifierTypeStateIssuer
038009609MedicaidIL
2832008OtherILBLUE CROSS BLUE SHIELD
626640OtherHEALTHLINK
226906OtherGHP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000050 IL Practitioner - Chiropractic 2961699707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

509 W Main St
Benton, IL 62812-1328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teel Chiropractic Clinic, LTD. CurrentSince Sep 3, 2003 Accepting new patients

Locations

509 W Main St
Benton, IL 62812
Phone (618) 439-7171

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1265533418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W MAIN STREET",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121328",
            "telephone_number": "618-439-7171",
            "fax_number": "618-439-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W MAIN STREET",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121328",
            "telephone_number": "618-439-7171",
            "fax_number": "618-439-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEL",
        "first_name": "JULIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009609",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2832008",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "626640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "226906",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.