NPIMap

Organization Active NPI

Medicinal Chiropractic LLC

  • Chiropractor
  • Crystal Lake, IL
National Provider Identifier
1548047038
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MEDICINAL CHIROPRACTIC LLC
Practice address
820 E Terra Cotta Ave Ste 253
Crystal Lake, IL 60014-3655
Phone
(224) 944-3973
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Tyler Dahlke, DCNPI 1396271789
Title
Owner/Chiropractor
Phone
(224) 944-3973

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

820 E Terra Cotta Ave Ste 253
Crystal Lake, IL 60014-3655

Mailing address

820 E Terra Cotta Ave Ste 253
Crystal Lake, IL 60014-3655
Phone (224) 944-3973

Other practice location 1

820 E Terra Cotta Ave Ste 253
Crystal Lake, IL 60014-3655
Phone (224) 944-3973

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.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1548047038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 253",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143655",
            "telephone_number": "224-944-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 253",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143655",
            "telephone_number": "224-944-3973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 E Terra Cotta Ave Ste 253",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600143655",
            "country_code": "US",
            "telephone_number": "224-944-3973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICINAL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A",
        "authorized_official_last_name": "DAHLKE",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "224-944-3973",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.