Champaign Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CHAMPAIGN CLINIC INC

Practice address

1207 S Mattis Ave Ste 2
Champaign, IL 61821-4861

Phone

(217) 355-5922

Fax

(217) 355-5925

NPI assigned

Jul 2, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Douglas Stachnik, DCNPI 1720038128

Title

Owner/Doctor

Phone

(217) 355-5922

Specialties & licenses 1

Addresses

Other names 1

• Champaign Chiropractic Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Kevin Stachnik, D.C.

  • Chiropractor
  • Champaign, IL
  • NPI 1720038128
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1316783178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 S MATTIS AVE STE 2",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618214861",
            "telephone_number": "217-355-5922",
            "fax_number": "217-355-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 S MATTIS AVE STE 2",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618214861",
            "telephone_number": "217-355-5922",
            "fax_number": "217-355-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "STACHNIK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "217-355-5922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champaign Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Champaign Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmin Chamberlain
• Devin Henry Chambers
• Champaign Behavioral Health LLC
• Champaign Behavioral Health LLC
• Champaign Chiropractic LLC
• Champaign County Health Care Consumers
• Champaign County YMCA
• Champaign Cu School District
• Champaign Endodontics PLLC
• Champaign Integrative Clinic, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.