NPIMap

Organization Active NPI

McGuire Chiropractic Clinic S.C.

  • Chiropractor
  • Benton, IL
National Provider Identifier
1689716359
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
042617953 Issued in IL
Legal business name
MCGUIRE CHIROPRACTIC CLINIC S.C.
Practice address
805 N Main St
Benton, IL 62812-1019
Phone
(618) 435-2500
Fax
(618) 438-5119
NPI assigned
Feb 12, 2007
Last updated
Jan 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Dr. Dennis Ray McGuire, D.C.
Title
President/Owner
Phone
(618) 435-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 042617953 IL Primary

Addresses

Primary practice location

805 N Main St
Benton, IL 62812-1019

Mailing address

805 N Main St
Benton, IL 62812-1019
Phone (618) 435-2500

Other identifiers 3

IdentifierTypeStateIssuer
038008385MedicaidIL
404465OtherILHEALTHLINK
2823412OtherILBLUE CROSS & BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

805 N Main St
Benton, IL 62812
Phone (618) 435-2500

Practitioners & affiliated clinicians

Practitioners 1

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1689716359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121019",
            "telephone_number": "618-435-2500",
            "fax_number": "618-438-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121019",
            "telephone_number": "618-435-2500",
            "fax_number": "618-438-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGUIRE CHIROPRACTIC CLINIC S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "MCGUIRE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "618-435-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "042617953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008385",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "404465",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "2823412",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.