Chad Christian Wyatt, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

03801136 Issued in IL

Practice address

2202 Eastland Dr
Suite B
Bloomington, IL 61704-3585

Phone

(870) 822-0218

NPI assigned

Feb 5, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Healthy Living Family Chiropractic, P.C.

  • Chiropractor
  • Bloomington, IL
  • NPI 1033350657
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1326287939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 COUNTY ROAD 2100 N",
            "city": "WASHBURN",
            "state": "IL",
            "postal_code": "615709324",
            "telephone_number": "870-822-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EASTLAND DR",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043585",
            "telephone_number": "870-822-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "CHAD",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "03801136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin L Woolard
• Daniel Adam Wooldridge, MD
• Judy Lee Wright, M.D.
• Juliet Rene Wright, MS,LCPC
• Timothy Robert Wright
• Maranda Nicole Wyatt, D.C.
• Mark Alan Wynters, CPHT
• David Douglas Wyse, D.D.S.
• Courtney Yamada, PT, MS
• Aban Yaqub, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.