Individual provider Active NPI

Katrina McQuilkin, DC

  • Chiropractor
  • Peru, IL
National Provider Identifier
1265976641
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013051 Issued in IL
Practice address
3815 Progress Blvd Ste C
Peru, IL 61354-1188
Phone
(815) 250-0953
Fax
(779) 201-5194
NPI assigned
Dec 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013051 IL Primary

Addresses

Primary practice location

3815 Progress Blvd Ste C
Peru, IL 61354-1188

Mailing address

3815 Progress Blvd Ste C
Peru, IL 61354-1188
Phone (815) 250-0953

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228002177 IL Practitioner - Chiropractic 7416231980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3815 Progress Blvd
Suite C
Peru, IL 61354-1188
Phone (815) 250-0953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013051ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mac Chiropractic LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

3815 Progress Blvd
Ste C
Peru, IL 61354
Phone (815) 250-0953

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": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1265976641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 PROGRESS BLVD STE C",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541188",
            "telephone_number": "815-250-0953",
            "fax_number": "779-201-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 PROGRESS BLVD STE C",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541188",
            "telephone_number": "815-250-0953",
            "fax_number": "779-201-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILKIN",
        "first_name": "KATRINA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.