Kelly Dawn Chullen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038010250 Issued in IL

Practice address

120 E Herrin St
Herrin, IL 62948-3163

Phone

(618) 988-9830

Fax

(618) 988-9830

NPI assigned

Nov 6, 2006

Last updated

Oct 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Alternative Health Care, LLC

  • Rehabilitation Chiropractor
  • Marion, IL
  • NPI 1578693073
  NPD (past)
• Angela Baxter LLC

  • Chiropractor
  • Herrin, IL
  • NPI 1265637755
  NPD (past)
• Total Health Chiropractic

  • Chiropractor
  • Herrin, IL
  • NPI 1376973214
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1780753756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HERRIN ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483163",
            "telephone_number": "618-988-9830",
            "fax_number": "618-988-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HERRIN ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483163",
            "telephone_number": "618-988-9830",
            "fax_number": "618-988-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHULLEN",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2832012",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038010250",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chass Ventures PLLC Dba Peak Performance Health & Wellness
• Michele Cheatham
• Sherry Childers
• Christian Counseling Center
• Samantha Jo Christopher, APN
• Hollis Johnson Clark Jr., P.A.-C.
• Jaime Ann Clark, PH.D.
• Tiffany Colborn, NP
• Jennifer Ann Colboth, M.P.T.
• Carrie Collins, MS SLP

• Chiropractor in Herrin, IL
• Providers in Herrin, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.