Gill Family Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1048012 Issued in WI

Legal business name

GILL FAMILY CHIROPRACTIC

Practice address

104 E Walworth Ave
Suite 102
Delavan, WI 53115-1146

Phone

(262) 725-7325

Fax

(888) 556-3358

NPI assigned

Jan 6, 2010

Last updated

Jun 9, 2010By 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

Tara Marie Gill, DCNPI 1003975129

Title

Chiropractor

Phone

(262) 725-7325

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

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.

• Tara Marie Gill, DC

  • Chiropractor
  • Pewaukee, WI
  • NPI 1003975129
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1720318264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E WALWORTH AVE",
            "address_2": "SUITE 102",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151146",
            "telephone_number": "262-725-7325",
            "fax_number": "888-556-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E WALWORTH AVE",
            "address_2": "SUITE 102",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151146",
            "telephone_number": "262-725-7325",
            "fax_number": "888-556-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILL FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "262-725-7325",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1048012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38961000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destry Allen Fritz, COTA
• Furnishing Solutions (Slumberland)
• Maria Teresa Galgano Chadha, DDS
• Javier Gallegos, M.D.
• Natasha Marie Garza, LPN
• Christopher J Gilman, MD
• Kristin M Grenier, L.P.T.A.
• Christine Susanne Gressick, R.N.
• Rachel Tara Joy Gronau, MD
• Patricia Conlon Grosso, OTR/L

• Chiropractor in Delavan, WI
• Providers in Delavan, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.

Verify at the official NPI Registry.