Joshua Berven, DC
Individual provider Active NPI Chiropractor · Freeport, IL
NPI 1679989404 · NPPES record last updated May 20, 2024
Key facts
- NPI
- 1679989404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038.013304 (IL)
- Practice address
- 641 W Stephenson St
Freeport, IL 61032-5005 - Phone
- (815) 238-9629
- NPI assigned
- Jul 1, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6921 Alvina Rd
Rockford, IL 61101-7950
Phone (815) 238-9629
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190108000315 | IL | Practitioner - Chiropractic | 6103162482 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.013304 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Way Chiropractic PLLC | Current |
Accepting new patients |
Locations
641 W Stephenson St
Ste 3
Freeport, IL 61032
Phone (815) 238-9629
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.013304 | IL | Yes |
Addresses
Primary practice location
641 W Stephenson St
Freeport, IL 61032-5005
Mailing address
6921 Alvina Rd
Rockford, IL 61101-7950
Phone (515) 570-7297
Other practice location 1
6921 Alvina Rd
Rockford, IL 61101-7950
Phone (515) 570-7297
Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.