Individual provider Active NPI

Michael Donald Piller, D.C.

  • Sports Physician Chiropractor
  • Peru, IL
National Provider Identifier
1316044084
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Practice address
2011 Rock St
Suite F
Peru, IL 61354-1385
Phone
(815) 224-8090
Fax
(815) 224-8091
NPI assigned
Sep 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X IL Primary

Addresses

Primary practice location

2011 Rock St
Suite F
Peru, IL 61354-1385

Mailing address

2011 Rock St
Suite F
Peru, IL 61354-1385
Phone (815) 224-8090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000343 IL Practitioner - Chiropractic 7911974613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5304 Williams Dr
Roscoe, IL 61073-7320
Phone (815) 623-3379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009709ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Chiropractic Wellness, Inc CurrentSince Feb 1, 2013 Accepting new patients
Timothy J Mertes and Michael D Piller Partners Sports Physician CurrentSince Sep 1, 2006 Accepting new patients
Hulsebus Rockford Chiropractic PastSince Jan 1, 2010 Accepting new patients
Kavai Chiropractic & Wellness Center Past Accepting new patients
Karin Stoll, MSW, DCSW Past Accepting new patients
Kauai Chiropractic and Wellness Center, LLC PastSince Apr 16, 2018 Accepting new patients
New Life Health & Wellness LLC PastSince Feb 19, 2023 Accepting new patients

Locations

2011 Rock St
Ste F
Peru, IL 61354
Phone (815) 224-8090

5304 Williams Dr
Roscoe, IL 61073
Phone (815) 623-3379

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316044084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 ROCK ST",
            "address_2": "SUITE F",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541385",
            "telephone_number": "815-224-8090",
            "fax_number": "815-224-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 ROCK ST",
            "address_2": "SUITE F",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541385",
            "telephone_number": "815-224-8090",
            "fax_number": "815-224-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLER",
        "first_name": "MICHAEL",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": null,
            "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 Jul 8, 2007; 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.