Theresa Renee Illingsworth, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

06395 Issued in IA

Practice address

3267 Ridge PT
Bettendorf, IA 52722-5312

Phone

(563) 332-2345

Fax

(563) 332-1606

NPI assigned

Jan 25, 2006

Last updated

Dec 10, 2009By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daehler Family Chiropractic

  • Chiropractor
  • Bettendorf, IA
  • NPI 1437882289
  NPD (past)
• Slavens Family Chiropractic, PC

  • Chiropractor
  • Bettendorf, IA
  • NPI 1346255106
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1427028133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 RIDGE PT",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527225312",
            "telephone_number": "563-332-2345",
            "fax_number": "563-332-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 RIDGE PT",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527225312",
            "telephone_number": "563-332-2345",
            "fax_number": "563-332-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLINGSWORTH",
        "first_name": "THERESA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.