John R Wasem DC PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIROPRACTOR Issued in IL

Legal business name

JOHN R WASEM DC PC

Practice address

1358 N Oakland Ave
Decatur, IL 62526-3737

Phone

(217) 428-2322

Fax

(217) 428-1170

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John R Wasem, DC

Title

Corporation President

Phone

(217) 428-2322

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699894287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 N OAKLAND AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263737",
            "telephone_number": "217-428-2322",
            "fax_number": "217-428-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 N OAKLAND AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263737",
            "telephone_number": "217-428-2322",
            "fax_number": "217-428-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R WASEM DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "217-428-2322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "CHIROPRACTOR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0005821789",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Decatur, IL
• Providers in Decatur, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.