Organization Active NPI

Mance Chiropractic LTD

  • Chiropractor
  • Morrison, IL
National Provider Identifier
1578673299
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MANCE CHIROPRACTIC LTD
Practice address
125 East Main Street
Morrison, IL 61270-2639
Phone
(815) 772-7641
Fax
(815) 772-7642
NPI assigned
Aug 30, 2006
Last updated
Feb 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Mr. Gerald Lee Mance, DC
Title
President
Phone
(815) 772-7641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

125 East Main Street
Morrison, IL 61270-2639

Mailing address

125 East Main Street
Morrison, IL 61270-2639
Phone (815) 772-7641

Other identifiers 3

IdentifierTypeStateIssuer
1720265572OtherNPI
612270MedicaidIL
9882009OtherILBLUE CROSS BLUE SHIELD

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, 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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1578673299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EAST MAIN STREET",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612702639",
            "telephone_number": "815-772-7641",
            "fax_number": "815-772-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EAST MAIN STREET",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612702639",
            "telephone_number": "815-772-7641",
            "fax_number": "815-772-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCE CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "MANCE",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-772-7641",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720265572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612270",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9882009",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.