Kevin J Russeau, DC, DIBCN, DABFP

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

038-007072 Issued in IL

Practice address

311 S Naperville Rd
Suite C
Wheaton, IL 60187-5473

Phone

(630) 690-4040

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wheaton Healthcare, LLC

  • Rehabilitation Chiropractor
  • Wheaton, IL
  • NPI 1831692912
  NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1508870080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S NAPERVILLE RD",
            "address_2": "SUITE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875473",
            "telephone_number": "630-690-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S NAPERVILLE RD",
            "address_2": "SUITE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875473",
            "telephone_number": "630-690-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSEAU",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC, DIBCN, DABFP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038-007072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "79863",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4655917",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8228039001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "022-22298",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl A Ruiz, BSN
• Tessa Ruiz, BCBA
• Julie Beth Rule Ong, MSW, LSW
• Chaynee Rummel, LCPC, CADC
• Russeau Team Healthcare, LTD.
• Frank H Russo, D.P.M.
• Ruth C. Martens, M.D.
• Alyssa Cosme Ryan, MSW, LCSW
• Colleen Rymut, BSN, RN
• Kendall Maree Ryndak Samuel, BCBA

• Neurology Chiropractor in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Neurology Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.