Organization Active NPI

Marion Family Chiropractic, PLLC

  • Chiropractor
  • Marion, IL
National Provider Identifier
1578384657
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MARION FAMILY CHIROPRACTIC, PLLC
Practice address
301 N Van Buren St
Marion, IL 62959-2335
Phone
(618) 694-9797
NPI assigned
Oct 21, 2024
Last updated
Oct 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Emily Dickman, DCNPI 1093465049
Title
Chiropractic Physician
Phone
(618) 694-9797

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
Chiropractor 111N00000X Primary

Addresses

Primary practice location

301 N Van Buren St
Marion, IL 62959-2335

Mailing address

2335 Lakeshore Dr S
Goreville, IL 62939-3167
Phone (618) 694-9797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250206001124 IL Part B Supplier - Clinic/Group Practice 7416487459 Receives reassigned benefits from 1 practitioner
Practice locations: Marion, IL

National Provider Directory

National Provider Directory

Locations

301 N Van Buren St
Marion, IL 62959
Phone (618) 694-9797

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1578384657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 LAKESHORE DR S",
            "city": "GOREVILLE",
            "state": "IL",
            "postal_code": "629393167",
            "telephone_number": "618-694-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N VAN BUREN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592335",
            "telephone_number": "618-694-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "618-694-9797",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.