Rhett Charles Gunderson, D.C.
Individual provider Active NPI Chiropractor · Rockton, IL
NPI 1497067433 · NPPES record last updated Jul 7, 2010
Key facts
- NPI
- 1497067433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038011727 (IL)
- Practice address
- 506 S Blackhawk Blvd
Rockton, IL 61072-2908 - Phone
- (815) 624-2669
- NPI assigned
- Jul 7, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2010
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Gunderson Clinic of Chiropractic Inc.
Practice addresses (Care Compare)
506 S Blackhawk Blvd
Rockton, IL 61072-2908
Phone (815) 624-2669
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100929001564 | IL | Practitioner - Chiropractic | 9032235742 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gunderson Clinic of Chiropractic Inc. | Chiropractor | Current |
Accepting new patients |
Locations
506 S Blackhawk Blvd
Rockton, IL 61072
Phone (815) 624-2669
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038011727 | IL | Yes |
Addresses
Primary practice location
506 S Blackhawk Blvd
Rockton, IL 61072-2908
Mailing address
506 S Blackhawk Blvd
Rockton, IL 61072-2908
Phone (815) 624-2669
Other providers in Rockton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2010. 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.