Tiffany Zimmerman DC PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038010770 Issued in IL

Legal business name

TIFFANY ZIMMERMAN DC PC

Practice address

610 19TH St
Moline, IL 61265-2142

Phone

(309) 762-1050

NPI assigned

Feb 12, 2009

Organization subpart

No

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

Authorized official

Name

Tiffany Ann Willard, DCNPI 1861522195

Title

Authorized Official

Phone

(309) 762-1050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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

• Tiffany Ann Willard, D.C.

  • Chiropractor
  • Moline, IL
  • NPI 1861522195
  Medicare reassignment Authorized official
• Richard Gary Fried, D.C.

  • Chiropractor
  • Moline, IL
  • NPI 1710984174
  NPD (past)
• Geraldine Marie Kruckenberg, DC

  • Chiropractor
  • Moline, IL
  • NPI 1225039324
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1306085428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 19TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652142",
            "telephone_number": "309-762-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 19TH ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652142",
            "telephone_number": "309-762-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY ZIMMERMAN DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "WILLARD",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "309-762-1050",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas D Ade MD PLLC
• Bryce Thomsen, DPT
• Tara Thor
• Jon Thoreson, PT
• Kimberly S. Thrush, LCSW, LISW
• Craig P. Tillman, M.D.
• Laura Timmerman
• Joan Timmermann, LCSW
• Brian Sheng Ting, DPM
• Chanda Ting, D.C.

• Chiropractor in Moline, IL
• Providers in Moline, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.