Thea C. Flock, D.C., S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

042.618103 Issued in IL

Legal business name

THEA C. FLOCK, D.C., S.C.

Practice address

440 Quadrangle Dr
Suite E
Bolingbrook, IL 60440-3454

Phone

(630) 771-9662

Fax

(630) 771-9663

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thea C Flock, D.C.

Title

President-Owner

Phone

(630) 771-9662

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Rafael A Perez-Guerra, MD

  • Family Medicine Physician
  • Crest Hill, IL
  • NPI 1578653994
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1336293968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 QUADRANGLE DR",
            "address_2": "SUITE E",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403454",
            "telephone_number": "630-771-9662",
            "fax_number": "630-771-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 QUADRANGLE DR",
            "address_2": "SUITE E",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403454",
            "telephone_number": "630-771-9662",
            "fax_number": "630-771-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEA C. FLOCK, D.C., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "FLOCK",
        "authorized_official_first_name": "THEA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "630-771-9662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "042.618103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "09932027",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.