Individual provider Active NPI

Benjamin Miles, D.C.

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1609160654
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-011932 Issued in IL
Practice address
4300 N Brandywine Dr
Peoria, IL 61614-5550
Phone
(309) 338-3301
Fax
(309) 332-7770
NPI assigned
Jun 7, 2011
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-011932 IL Primary

Addresses

Primary practice location

4300 N Brandywine Dr
Peoria, IL 61614-5550

Mailing address

118 N Broadway St
Lewistown, IL 61542-1202
Phone (309) 338-3301

Other identifiers 1

IdentifierTypeStateIssuer
038-011932OtherILSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000746 IL Practitioner - Chiropractic 1355519695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4300 N Brandywine Dr
Peoria, IL 61614-5550
Phone (309) 338-3301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-011932ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Neuromed Healthcare PLLC CurrentSince Sep 25, 2025 Accepting new patients
Realhealth Advanced Care SC CurrentSince Apr 18, 2023 Accepting new patients
Hulsebus and Gehlsen Chiropractic Chiropractor PastSince Jun 20, 2008 Accepting new patients
Pecatonica Chiropractic Center Chiropractor PastSince Dec 1, 2014 Accepting new patients

Locations

328 W Washington St
East Peoria, IL 61611
Phone (309) 682-9000

4300 N Brandywine Dr
Peoria, IL 61614
Phone (309) 338-3301

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1609160654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N BROADWAY ST",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615421202",
            "telephone_number": "309-338-3301",
            "fax_number": "309-332-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 N BRANDYWINE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145550",
            "telephone_number": "309-338-3301",
            "fax_number": "309-332-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "BENJAMIN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "038-011932",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.