NPIMap

Organization Active NPI

Dr Thomas M Kovacik

  • Chiropractor
  • Galesburg, IL
National Provider Identifier
1760594261
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038003797 Issued in IL
Legal business name
DR THOMAS M KOVACIK
Practice address
1128 Monroe Street
Galesburg, IL 61401
Phone
(309) 342-9147
Fax
(309) 342-9147
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. Thomas Michael Kovacik, DCNPI 1003928508
Title
Owner
Phone
(309) 342-9147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038003797 IL Primary

Addresses

Primary practice location

1128 Monroe Street
Galesburg, IL 61401

Mailing address

1128 Monroe Street
Galesburg, IL 61401
Phone (309) 342-9147

Other identifiers 2

IdentifierTypeStateIssuer
791350632OtherRR MEDICARE
04832003OtherBCBS

Other names 1

  • Knox County Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1760594261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 MONROE STREET",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-342-9147",
            "fax_number": "309-342-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 MONROE STREET",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-342-9147",
            "fax_number": "309-342-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR THOMAS M KOVACIK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "KOVACIK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-342-9147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038003797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "791350632",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04832003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knox County Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.