Individual provider Active NPI

Kenneth Torell Kruchten, D.C.

  • Sports Physician Chiropractor
  • Crest Hill, IL
National Provider Identifier
1730216532
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Practice address
2430 Plainfield Rd
Crest Hill, IL 60435-1467
Phone
(815) 439-2120
Fax
(815) 432-6201
NPI assigned
Feb 27, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X IL Primary

Addresses

Primary practice location

2430 Plainfield Rd
Crest Hill, IL 60435-1467

Mailing address

2430 Plainfield Rd
Crest Hill, IL 60435-1467
Phone (815) 439-2120

Other identifiers 1

IdentifierTypeStateIssuer
9982032OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000145 IL Practitioner - Chiropractic 6709840531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crest Hill Clinic, LTD.Group PAC ID 3577952761, 5 clinicians

Practice addresses (Care Compare)

2430 Plainfield Rd
Suite 1a
Crest Hill, IL 60403-1467
Phone (815) 439-2120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-005663ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crest Hill Clinic LTD CurrentSince Jan 1, 2022 Accepting new patients
Kruchten Clinic of Chiropractic PastSince Jan 1, 1990 Accepting new patients
Kenneth Kruchten, DC Sports Physician PastSince Jan 1, 1990 Accepting new patients
Energy Healing Systems Inc Past Accepting new patients

Locations

2430 Plainfield Rd
Ste 1A
Crest Hill, IL 60403
Phone (815) 439-2120

2430 Plainfield Rd
Joliet, IL 60403
Phone (815) 439-2120

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730216532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 PLAINFIELD RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604351467",
            "telephone_number": "815-439-2120",
            "fax_number": "815-432-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 PLAINFIELD RD",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604351467",
            "telephone_number": "815-439-2120",
            "fax_number": "815-432-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCHTEN",
        "first_name": "KENNETH",
        "middle_name": "TORELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9982032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.