Clem Chiropractic Center
Organization Active NPI Chiropractor · Auburn, IL
NPI 1689708489 · NPPES record last updated Apr 13, 2011
Key facts
- NPI
- 1689708489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038-009051 (IL)
- Legal business name
- CLEM CHIROPRACTIC CENTER
- Practice address
- 412 W Jefferson St
Auburn, IL 62615-1425 - Phone
- (217) 438-6324
- NPI assigned
- Mar 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher Erick Clem, D.C.
- Title
- Owner
- Phone
- (217) 438-6324
Member of 1
Practitioners 2
-
Christopher Erick Clem, D.C.
-
Kyle Wayne Nevill, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050913001226 | IL | Part B Supplier - Clinic/Group Practice | 4688607351 |
Receives reassigned benefits from 2 practitioners Practice locations: Auburn, IL |
National Provider Directory
Locations
412 W Jefferson St
Auburn, IL 62615
Phone (217) 438-6324
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 038-009051 | IL | Yes |
Addresses
Primary practice location
412 W Jefferson St
Auburn, IL 62615-1425
Mailing address
412 W Jefferson St
Auburn, IL 62615-1425
Phone (217) 438-6324
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8427806 | Other | IL | BLUE CROSS BLUE SHIELD |
| 038-009051 | Medicaid | IL |
Other providers in Auburn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2011. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.