Organization Active NPI

Harris Chiropractic Clinic LLC

  • Chiropractor
  • Moline, IL
National Provider Identifier
1639986987
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HARRIS CHIROPRACTIC CLINIC LLC
Practice address
3610 25TH St Ste 1
Moline, IL 61265-7261
Phone
(309) 737-4163
NPI assigned
Dec 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Dr. Julia Lynn Harris, DCNPI 1174344329
Title
Chiropractor
Phone
(309) 737-4163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3610 25TH St Ste 1
Moline, IL 61265-7261

Mailing address

1002 23Rd St
Moline, IL 61265-2257
Phone (309) 737-4163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250122000165 IL Part B Supplier - Clinic/Group Practice 2264961135 Receives reassigned benefits from 1 practitioner
Practice locations: Moline, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1639986987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 23RD ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612652257",
            "telephone_number": "309-737-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 25TH ST STE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657261",
            "telephone_number": "309-737-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "309-737-4163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.