Individual provider Active NPI

Daniel Thomas McConnell, D.C.

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1457411159
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
1605 W Candletree Dr
Suite 101
Peoria, IL 61614-1562
Phone
(309) 692-2230
Fax
(309) 692-6136
NPI assigned
Dec 11, 2006
Last updated
Oct 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

1605 W Candletree Dr
Suite 101
Peoria, IL 61614-1562

Mailing address

1605 W Candletree Dr
Suite 101
Peoria, IL 61614-1562
Phone (309) 692-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038003615ILMDChiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1457411159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W CANDLETREE DR",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141562",
            "telephone_number": "309-692-2230",
            "fax_number": "309-692-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W CANDLETREE DR",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141562",
            "telephone_number": "309-692-2230",
            "fax_number": "309-692-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.