Daniel A Iliff, DC
Individual provider Active NPI Chiropractor · Coloma, MI
NPI 1386848745 · NPPES record last updated Mar 15, 2017
Key facts
- NPI
- 1386848745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DI009262 (MI)
- Practice address
- 6560 Red Arrow Highway
Coloma, MI 49038 - Phone
- (269) 468-5775
- Fax
- (269) 468-3447
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2560 S Cleveland Ave
Suite 4
Saint Joseph, MI 49085-2641
Phone (269) 983-1800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080314000544 | MI | Practitioner - Chiropractic | 9638254618 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI009262 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iliff Chiropractic | Chiropractor | Current |
Accepting new patients |
| Startup Center for Inner Peace, PLLC | Past | Accepting new patients |
Locations
2560 S Cleveland Ave
Ste 4
Saint Joseph, MI 49085
Phone (269) 982-1611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DI009262 | MI | Yes |
Addresses
Primary practice location
6560 Red Arrow Highway
Coloma, MI 49038
Mailing address
2560 S Cleveland Ave
Ste 4
Saint Joseph, MI 49085-2641
Phone (269) 983-1800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DI009262 | Other | MI | STATE LISCENSE NUMBER |
| 950A101140 | Other | MI | BLUE CROSS BLUE SHIELD |
Other providers in Coloma, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.