Organization Active NPI

Andreas Chiropractic, P.C.

  • Chiropractor
  • Troy, IL
National Provider Identifier
1730201716
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
060.008479 Issued in IL
Legal business name
ANDREAS CHIROPRACTIC, P.C.
Practice address
503 Buckeye Dr
Ste 130
Troy, IL 62294-2347
Phone
(618) 667-1670
Fax
(618) 667-1671
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Bryan Michael Andreas, D.C.
Title
President
Phone
(618) 667-1670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 060.008479 IL Primary

Addresses

Primary practice location

503 Buckeye Dr
Ste 130
Troy, IL 62294-2347

Mailing address

503 Buckeye Dr
Ste 130
Troy, IL 62294-2347
Phone (618) 667-1670

Other identifiers 3

IdentifierTypeStateIssuer
477681OtherILHEALTHLINK ID#
POO107103OtherILRAILROAD MEDICARE#
06032046OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

503 Buckeye Dr
Ste 130
Troy, IL 62294
Phone (618) 667-1670

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1730201716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 BUCKEYE DR",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622942347",
            "telephone_number": "618-667-1670",
            "fax_number": "618-667-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 BUCKEYE DR",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622942347",
            "telephone_number": "618-667-1670",
            "fax_number": "618-667-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREAS CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ANDREAS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-667-1670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "060.008479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK ID#",
            "identifier": "477681",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE#",
            "identifier": "POO107103",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06032046",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.