NPIMap

Organization Active NPI

Koehler Sports & Spinal Rehab LTD

  • Chiropractor
  • Bourbonnais, IL
National Provider Identifier
1659450815
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038005929 Issued in IL
Legal business name
KOEHLER SPORTS & SPINAL REHAB LTD
Practice address
232 Main St NW
Suite 201
Bourbonnais, IL 60914-1938
Phone
(815) 939-4900
Fax
(815) 939-4951
NPI assigned
Nov 6, 2006
Last updated
May 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Authorized official

Name
Dr. Thomas D Koehler, DC CCSPNPI 1215047824
Title
Owner Provider
Phone
(815) 939-4900

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
Chiropractor 111N00000X 038005929 IL Primary

Addresses

Primary practice location

232 Main St NW
Suite 201
Bourbonnais, IL 60914-1938

Mailing address

232 Main NW
Suite 201
Bourbonnais, IL 60914
Phone (815) 939-4900

Other identifiers 1

IdentifierTypeStateIssuer
03800J929MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1659450815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 MAIN NW",
            "address_2": "SUITE 201",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-939-4900",
            "fax_number": "815-939-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 MAIN ST NW",
            "address_2": "SUITE 201",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141938",
            "telephone_number": "815-939-4900",
            "fax_number": "815-939-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOEHLER SPORTS & SPINAL REHAB LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "815-939-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC CCSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03800J929",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.