NPIMap

Organization Active NPI

David Low Back Center DC

  • Chiropractor
  • Freeport, IL
National Provider Identifier
1346376241
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DAVID LOW BACK CENTER DC
Practice address
1019 W Galena Ave
Freeport, IL 61032-3819
Phone
(815) 232-2225
Fax
(815) 233-2571
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Paul M Theisen, D.C.NPI 1639136278
Title
Owner
Phone
(815) 232-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 070022643 IL

Addresses

Primary practice location

1019 W Galena Ave
Freeport, IL 61032-3819

Mailing address

1019 W Galena Ave
Freeport, IL 61032-3819
Phone (815) 232-2225

Other names 1

  • Chiro-Works Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020001238 IL Part B Supplier - Clinic/Group Practice 2062473325 Receives reassigned benefits from 4 practitioners
Practice locations: Freeport, IL

National Provider Directory

National Provider Directory
Tax ID family
Chiro-Works2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1346376241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323819",
            "telephone_number": "815-232-2225",
            "fax_number": "815-233-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323819",
            "telephone_number": "815-232-2225",
            "fax_number": "815-233-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID LOW BACK CENTER DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "THEISEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-232-2225",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiro-Works",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.