Jay M Bersche, D.C.
Individual provider Active NPI Chiropractor · Normal, IL
NPI 1306876511 · NPPES record last updated Jul 25, 2023
Key facts
- NPI
- 1306876511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38010312 (IL)
- Practice address
- 1603 Visa Dr
Normal, IL 61761-2131 - Phone
- (309) 269-9000
- Fax
- (309) 268-9003
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allied Health Group, LTD
Practice addresses (Care Compare)
1603 Visa Dr
Normal, IL 61761-2131
Phone (309) 268-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050419000842 | IL | Practitioner - Chiropractic | 8426096637 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38010312 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38010312 | IL | Yes |
Addresses
Primary practice location
1603 Visa Dr
Normal, IL 61761-2131
Mailing address
1603 Visa Dr
Normal, IL 61761-2131
Phone (309) 268-9000
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2023. 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.