NPIMap

Organization Active NPI

Advanced Chiro-Med Pain and Diet Center, SC

Doing business as CHIRO-MED Pain and Diet Center

  • Chiropractor
  • Belvidere, IL
National Provider Identifier
1487887279
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007076 Issued in IL
Legal business name
ADVANCED CHIRO-MED PAIN AND DIET CENTER, SC
Doing business as
CHIRO-MED Pain and Diet Center
Practice address
860 Biester Dr
Ste 103
Belvidere, IL 61008-4053
Phone
(815) 544-3894
Fax
(815) 547-3968
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Authorized official

Name
Dr. Robert Dyer, DCNPI 1972670776
Title
President
Phone
(815) 544-3894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038007076 IL Primary

Addresses

Primary practice location

860 Biester Dr
Ste 103
Belvidere, IL 61008-4053

Mailing address

860 Biester Dr
Ste 103
Belvidere, IL 61008-4053
Phone (815) 544-3894

Other identifiers 1

IdentifierTypeStateIssuer
05207617OtherILBLUECROSS/BLUESHEILD

Other names 1

  • CHIRO-MED Pain and Diet Center Doing business as

National Provider Directory

National Provider Directory

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": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1487887279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BIESTER DR",
            "address_2": "STE 103",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610084053",
            "telephone_number": "815-544-3894",
            "fax_number": "815-547-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 BIESTER DR",
            "address_2": "STE 103",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610084053",
            "telephone_number": "815-544-3894",
            "fax_number": "815-547-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIRO-MED PAIN AND DIET CENTER, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-544-3894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHEILD",
            "identifier": "05207617",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIRO-MED Pain and Diet Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.