Vandevelde Wellness Center SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-011053 Issued in IL

Legal business name

VANDEVELDE WELLNESS CENTER SC

Practice address

615 Hollis St
Kewanee, IL 61443-3730

Phone

(309) 852-3939

Fax

(309) 852-3911

NPI assigned

Aug 26, 2010

Organization subpart

Yes

Parent organization

VANDEVELDE WELLNESS CENTER SCAs reported in NPPES

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

Authorized official

Name

Chad VandeveldeNPI 1154502961

Title

Owner

Phone

(309) 852-3939

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Vandevelde Wellness Center SC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad E Vandevelde, DC

  • Chiropractor
  • Washington, IL
  • NPI 1154502961
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368144000000",
    "number": "1568778678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOLLIS ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433730",
            "telephone_number": "309-852-3939",
            "fax_number": "309-852-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOLLIS ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433730",
            "telephone_number": "309-852-3939",
            "fax_number": "309-852-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDEVELDE WELLNESS CENTER SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VANDEVELDE WELLNESS CENTER SC",
        "enumeration_date": "2010-08-26",
        "last_updated": "2013-05-10",
        "status": "A",
        "authorized_official_last_name": "VANDEVELDE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-852-3939"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Patrick Tex, CRNA
• Taylor Anne Tobin
• Douglas Arthur Tomlinson, D.M.D.
• Sara Suzanne Umphfleet, RD, LDN
• Ernst Peter Unhold
• Kylee Wagenecht
• Wal-Mart Stores, Inc (Vision Center 30-0633)
• Walgreen Co (Walgreens #05511)
• Lauren Marie Wall
• Walmart Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.