Kankakee Valley Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011709 Issued in IL

Legal business name

KANKAKEE VALLEY CHIROPRACTIC

Practice address

300 North Kennedy Drive
Suite 2
Bradley, IL 60915

Phone

(815) 933-6624

Fax

(815) 933-6664

NPI assigned

Oct 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Blake William Randles, D.C.

Title

Ceo

Phone

(815) 933-6624

Specialties & licenses 1

Addresses

Locations

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.

• Ronald George Nowman, DC

  • Chiropractor
  • Bradley, IL
  • NPI 1104929769
  NPD (past)

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1538469655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NORTH KENNEDY DRIVE",
            "address_2": "SUITE 2",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "60915",
            "telephone_number": "815-933-6624",
            "fax_number": "815-933-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH KENNEDY DRIVE",
            "address_2": "SUITE 2",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "60915",
            "telephone_number": "815-933-6624",
            "fax_number": "815-933-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANKAKEE VALLEY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "RANDLES",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-933-6624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Jones, MD
• Joyful Smiles Pediatric Dentistry of Bradley
• Jonathan Eric Jusko, RN, PA-C
• Becky Kalvelage-Roth, PSYD
• Kankakee County Training Center for the Disabled, Inc.
• Katie Kasper, NP-C
• Jordan Kempes
• Michael Preston King, OTR/L
• Philip Kirk, LPC
• Kline Chiropractic LTD (Bradley Chiropractic)

• Chiropractor in Bradley, IL
• Providers in Bradley, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.