Courtney Rae Westefer, DC
Individual provider Active NPI Chiropractor · Wyoming, IL
NPI 1467057604 · NPPES record last updated Dec 4, 2020
Key facts
- NPI
- 1467057604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038.013641 (IL)
- Practice address
- 116 E Williams St
Wyoming, IL 61491-1455 - Phone
- (309) 695-4471
- NPI assigned
- Dec 4, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
116 E Williams St
Wyoming, IL 61491-1455
Phone (309) 695-4471
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210114001687 | IL | Practitioner - Chiropractic | 4981017886 | Practice locations: Wyoming, IL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.013641 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.013641 | IL | Yes |
Addresses
Primary practice location
116 E Williams St
Wyoming, IL 61491-1455
Mailing address
116 E Williams St
Wyoming, IL 61491-1455
Phone (309) 695-4471
Other providers in Wyoming, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2020. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.