Southern Illinois Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SOUTHERN ILLINOIS CHIROPRACTIC CENTER

Practice address

2 Professional Park Drive
Suite B
Maryville, IL 62062-5746

Phone

(618) 288-7991

Fax

(618) 288-7901

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Barry T Delassus, DCNPI 1427013283

Title

Owner Chiropractor

Phone

(618) 288-7991

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Barry T Delassus, D.C.

  • Chiropractor
  • Maryville, IL
  • NPI 1427013283
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407991771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PROFESSIONAL PARK DRIVE",
            "address_2": "SUITE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625746",
            "telephone_number": "618-288-7991",
            "fax_number": "618-288-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROFESSIONAL PARK DRIVE",
            "address_2": "SUITE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625746",
            "telephone_number": "618-288-7991",
            "fax_number": "618-288-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELASSUS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "618-288-7991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Edward Skelly, PT, DPT
• Deborah A Slemer, M.S, CCC-SLP
• Kolin Smith, B.S. CADC
• Jessica Marie Soens, RN
• Southern Illinois Associates LLC
• Southern Illinois Surgical Consultants S.C.
• Michael Southwick, CRNA
• Spinally Better, LLC
• SPS Surgical Services, SC
• SSM Medical Group

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.