Park Forest Chiropractic, LTD.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PARK FOREST CHIROPRACTIC, LTD.

Practice address

386 Forest Blvd
Park Forest, IL 60466-2005

Phone

(708) 481-1715

Fax

(708) 481-8915

NPI assigned

Mar 15, 2006

Last updated

Jan 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Tyssen, D.C.NPI 1982673265

Title

Owner

Phone

(708) 481-1715

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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.

• David Tyssen, D.C.

  • Chiropractor
  • Park Forest, IL
  • NPI 1982673265
  Medicare reassignment Authorized official
• Gary D Tennant, D.C.

  • Chiropractor
  • Park Forest, IL
  • NPI 1780653071
  Medicare reassignment

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1598734295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 FOREST BLVD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662005",
            "telephone_number": "708-481-1715",
            "fax_number": "708-481-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 FOREST BLVD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662005",
            "telephone_number": "708-481-1715",
            "fax_number": "708-481-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK FOREST CHIROPRACTIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "TYSSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-481-1715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "1622660",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Park Forest, IL
• Providers in Park Forest, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.