Organization Active NPI

Chiropractic Clinic of Quincy, LTD.

  • Chiropractor
  • Quincy, IL
National Provider Identifier
1275849101
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004861 Issued in IL
Legal business name
CHIROPRACTIC CLINIC OF QUINCY, LTD.
Practice address
422 Maine Street
Quincy, IL 62301-3930
Phone
(217) 222-4399
Fax
(217) 222-0480
NPI assigned
Aug 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Robert T Weckbach, DCNPI 1902987324
Title
Owner
Phone
(217) 222-4399

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038004861 IL Primary

Addresses

Primary practice location

422 Maine Street
Quincy, IL 62301-3930

Mailing address

422 Maine Street
Quincy, IL 62301-3930
Phone (217) 222-4399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110425000824 IL Part B Supplier - Clinic/Group Practice 3274718861 Receives reassigned benefits from 1 practitioner
Practice locations: Quincy, IL

National Provider Directory

National Provider Directory

Locations

422 Maine St
Quincy, IL 62301
Phone (217) 222-4399

Practitioners & affiliated clinicians

Practitioners 1

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": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1275849101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 MAINE STREET",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013930",
            "telephone_number": "217-222-4399",
            "fax_number": "217-222-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 MAINE STREET",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013930",
            "telephone_number": "217-222-4399",
            "fax_number": "217-222-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CLINIC OF QUINCY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "WECKBACH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-222-4399",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.