Harley Chiropractic, LLC
Organization Active NPI Chiropractor · Sullivan, IL
NPI 1427450220 · NPPES record last updated Sep 23, 2014
Key facts
- NPI
- 1427450220
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038010592 (IL)
- Legal business name
- HARLEY CHIROPRACTIC, LLC
- Practice address
- 221 N Anderson St
Sullivan, IL 61951-1001 - Phone
- (217) 728-8888
- NPI assigned
- Sep 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Katherine Harley, D.C.
- Title
- Owner
- Phone
- (217) 259-6338
Practitioners 3
-
Katherine Lynn Harley, D.C.
-
Nicolas L Kellerman, D.C.
-
Quintin Murray, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141114002083 | IL | Part B Supplier - Clinic/Group Practice | 3476775065 |
Receives reassigned benefits from 1 practitioner Practice locations: Sullivan, IL |
National Provider Directory
Locations
221 N Anderson St
Sullivan, IL 61951
Phone (217) 728-8888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 038010592 | IL | Yes |
Addresses
Primary practice location
221 N Anderson St
Sullivan, IL 61951-1001
Mailing address
221 N Anderson St
Sullivan, IL 61951-1001
Phone (217) 728-8888
Other providers in Sullivan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2014. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.