Individual provider Active NPI

Bryan Andrew Wills, DC

  • Chiropractor
  • Rochelle, IL
National Provider Identifier
1801832571
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38010005 Issued in IL
Practice address
102 Maple Ave
Rochelle, IL 61068-8926
Phone
(815) 562-5333
NPI assigned
Jun 21, 2006
Last updated
Jan 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38010005 IL Primary

Addresses

Primary practice location

102 Maple Ave
Rochelle, IL 61068-8926

Mailing address

102 Maple Ave
Rochelle, IL 61068-8926
Phone (815) 562-5333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000315 IL Practitioner - Chiropractic 1153216403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

102 Maple Ave
Rochelle, IL 61068-8926
Phone (815) 562-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38010005ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wills Chiropractic LLC Chiropractor CurrentSince Jul 12, 2014 Accepting new patients

Locations

102 Maple Ave
Rochelle, IL 61068
Phone (815) 562-5333

Organizations & group practices 1

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1801832571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MAPLE AVE",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610688926",
            "telephone_number": "815-562-5333",
            "fax_number": "815-562-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAPLE AVE",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610688926",
            "telephone_number": "815-562-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "BRYAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38010005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.