Small Miracles Chiropractic Clinic SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SMALL MIRACLES CHIROPRACTIC CLINIC SC

Practice address

110 SE Vine St Unit 2
Atlanta, IL 61723-7611

Phone

(217) 648-5555

NPI assigned

Oct 24, 2012

Last updated

Oct 24, 2012By 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. Staci Marie Hieronymus Kong, D.C.

Title

Chiropractic Physician

Phone

(217) 648-5555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1609129865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SE VINE ST UNIT 2",
            "city": "ATLANTA",
            "state": "IL",
            "postal_code": "617237611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SE VINE ST UNIT 2",
            "city": "ATLANTA",
            "state": "IL",
            "postal_code": "617237611",
            "telephone_number": "217-648-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL MIRACLES CHIROPRACTIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "HIERONYMUS KONG",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "217-648-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.