Charles C. Gerleman D C P C
Organization Active NPI Chiropractor · Galesburg, IL
NPI 1609096262 · NPPES record last updated Sep 20, 2024
Key facts
- NPI
- 1609096262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 060009011 (IL)
- Legal business name
- CHARLES C. GERLEMAN D C P C
- Practice address
- 777 N Henderson St
Galesburg, IL 61401-2515 - Phone
- (309) 343-2117
- Fax
- (309) 343-6639
- NPI assigned
- Apr 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Teresa L Peck, D.C.
- Title
- Clinic Director
- Phone
- (309) 343-2117
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080430000200 | IL | Part B Supplier - Clinic/Group Practice | 1153407440 |
Receives reassigned benefits from 6 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Galesburg, IL; Kewanee, IL; Milan, IL; Rushville, IL |
National Provider Directory
- Tax ID family
- C-Arles C Gerleman DC P
Locations
777 N Henderson St
Galesburg, IL 61401
Phone (309) 343-2117
504 1st St W
Milan, IL 61264
Phone (309) 787-4944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 060009011 | IL | Yes |
Addresses
Primary practice location
777 N Henderson St
Galesburg, IL 61401-2515
Mailing address
777 N Henderson St
Galesburg, IL 61401-2515
Phone (309) 343-2117
Other providers in Galesburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.