Leslie R Quiram, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

2412 E Washington St
Suite 9a
Bloomington, IL 61704-4497

Phone

(309) 662-6462

Fax

(309) 663-8812

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

Yes

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

• Quiram Spinal & Sports Rehabilitation LTD

  • Rehabilitation Chiropractor
  • Danvers, IL
  • NPI 1780760413

  IL

  Medicare reassignment Care Compare group Authorized official
• Zozzaro Group LLC

  • Chiropractor
  • Normal, IL
  • NPI 1568623114
  NPD (past)

Specialty

Chiropractic

Education

National College of Chiropractic, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quiram Spinal and Sports Rehabilitation LTD 2 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 4, 2007.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1467428409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 E WASHINGTON ST",
            "address_2": "SUITE 9A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044497",
            "telephone_number": "309-662-6462",
            "fax_number": "309-663-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 E WASHINGTON ST",
            "address_2": "SUITE 9A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044497",
            "telephone_number": "309-662-6462",
            "fax_number": "309-663-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIRAM",
        "first_name": "LESLIE",
        "middle_name": "R",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO PROVIDER #",
            "identifier": "5732002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bloomington, IL
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.