Active NPI
David Rousseau, D.C.
- Chiropractor
- Sandwich, IL
National Provider Identifier
1700900693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 919 E Church St
Sandwich, IL 60548-2215 - Phone
- (815) 786-7022
- NPI assigned
- Mar 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Primary |
Addresses
Primary practice location
919 E Church St
Sandwich, IL 60548-2215
Mailing address
919 E Church St
Sandwich, IL 60548-2215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982019 | Other | IL | BCBS PPO PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110209000447 | IL | Practitioner - Chiropractic | 3577743418 | Practice locations: Sandwich, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-005242 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700900693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 E CHURCH ST",
"city": "SANDWICH",
"state": "IL",
"postal_code": "605482215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 E CHURCH ST",
"city": "SANDWICH",
"state": "IL",
"postal_code": "605482215",
"telephone_number": "815-786-7022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSSEAU",
"first_name": "DAVID",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO PROVIDER",
"identifier": "1982019",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandwich, IL
- Dawn Kim Reynolds, RN
- Rezin Orthopedic & Sports Medicine, SC
- Rezin Orthopedic and Sports Medicine, SC
- Timothy Martin Rhoton, PMHNP
- Jason Lee Robinson, P.T.
- Sandwich Com SCH Dist 430
- Sandwich Community Fire Protection District
- Sandwich Dentistry LLC
- Sandwich Living & Rehab Center LLC
- Sandwich Medical Clinic SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.