Tara Jo Thompson, D.C.
Individual provider Active NPI Chiropractor · Wyanet, IL
NPI 1285629402 · NPPES record last updated Mar 29, 2012
Key facts
- NPI
- 1285629402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038007591 (IL)
- Practice address
- 102 W Main St.
Wyanet, IL 61379-0010 - Phone
- (815) 699-7333
- Fax
- (815) 699-7334
- NPI assigned
- Sep 14, 2005
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
102 W Main St
Wyanet, IL 61379-9690
Phone (815) 699-7333
102 W Main St / PO Box
Suite 10
Wyanet, IL 61379-0010
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040417000111 | IL | Practitioner - Chiropractic | 7315932530 | Practice locations: Wyanet, IL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038007591 | IL | Yes |
Addresses
Primary practice location
102 W Main St.
Wyanet, IL 61379-0010
Mailing address
P.O. Box 10
Wyanet, IL 61379-0010
Phone (815) 699-7333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350053822 | Other | IL | RAILROAD MEDICARE |
| 627456 | Other | IL | BCBS OF IL |
| 038007591 | Medicaid | IL |
Other names
- Dr. Tara Jo Linder
Other providers in Wyanet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.