Organization Active NPI

Lakeside Chiropractic, PLLC

  • Chiropractor
  • Normal, IL
National Provider Identifier
1437927985
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LAKESIDE CHIROPRACTIC, PLLC
Practice address
322 Susan Dr Ste B
Normal, IL 61761-6261
Phone
(309) 260-2146
Fax
(309) 260-2155
NPI assigned
Dec 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Dr. Sarah Elizabeth Weyhrich, DCNPI 1508430620
Title
Doctor/Owner
Phone
(309) 260-2146

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

322 Susan Dr Ste B
Normal, IL 61761-6261

Mailing address

322 Susan Dr Ste B
Normal, IL 61761-6261
Phone (309) 260-2146

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240909003761 IL Part B Supplier - Clinic/Group Practice 0941740658 Receives reassigned benefits from 1 practitioner
Practice locations: Normal, IL

National Provider Directory

National Provider Directory

Locations

322 Susan Dr
Ste B
Normal, IL 61761
Phone (309) 260-2146

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1437927985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 SUSAN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616261",
            "telephone_number": "309-260-2146",
            "fax_number": "309-260-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SUSAN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616261",
            "telephone_number": "309-260-2146",
            "fax_number": "309-260-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "WEYHRICH",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "309-260-2146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.