Philip L. Bolton, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0038-003600 Issued in IL

Practice address

211 S Prospect Rd Ste 5
Bloomington, IL 61704-4907

Phone

(309) 662-7788

NPI assigned

Jul 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

National College of Chiropractic, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336179225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S PROSPECT RD STE 5",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044907",
            "telephone_number": "309-662-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S PROSPECT RD STE 5",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044907",
            "telephone_number": "309-662-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "PHILIP",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "0038-003600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Boelen, M.D.
• Chasity Timeka Bogay, M.S., CCC-SLP
• Michelle Lynn Bognanno, M.A., CCC-SLP/L
• Kathryn Sue Bohn, M.D.
• Abby Lynn Bokus, LCSW
• Clinton Boone
• Andrea Bortell, L.AC
• Brenna Bortell
• Brittany N Bosley
• Donny Bounds, RN

• 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 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.