Paul M Theisen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038008781 Issued in IL

Practice address

1019 W Galena Ave
Freeport, IL 61032-3819

Phone

(815) 232-2225

Fax

(815) 233-2571

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• David Low Back Center DC

  • Chiropractor
  • Freeport, IL
  • NPI 1346376241
  Medicare reassignment NPD Authorized official
• David Low Back Center DC

  • Massage Therapist
  • Freeport, IL
  • NPI 1871028563
  NPD

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1639136278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323819",
            "telephone_number": "815-232-2225",
            "fax_number": "815-233-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W GALENA AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610323819",
            "telephone_number": "815-232-2225",
            "fax_number": "815-233-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "008922311",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Taylor
• Mark Steven Tedrow, RPH
• The Answer Physical Therapy & Medically Integrated Fitness LLC
• The Monroe Clinic, Inc.
• The Monroe Clinic, Inc.
• Tara H Theisen, D.C.
• Lisa Marie Then, OTA
• Theraplay of Northern Illinois
• Danaro Jerard Thomas
• Jacob Thomas

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.