Individual provider Active NPI

Susan Emily Ewen, D.C.

  • Chiropractor
  • Milan, IL
National Provider Identifier
1811299316
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011828 Issued in IL
Practice address
222 10TH Ave E # 52803
Milan, IL 61264-3114
Phone
(309) 787-9660
NPI assigned
Dec 3, 2010
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 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 038.011828 IL Primary

Addresses

Primary practice location

222 10TH Ave E # 52803
Milan, IL 61264-3114

Mailing address

2230 Scott St
Davenport, IA 52803-2715
Phone (563) 570-0812

Other practice location 1

3724 Blackhawk Road
Rock Island, IL 61201-9700
Phone (309) 786-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011828ILMDChiropractor

Organizations & group practices 2

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1811299316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 SCOTT ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032715",
            "telephone_number": "563-570-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 10TH AVE E # 52803",
            "city": "MILAN",
            "state": "IL",
            "postal_code": "612643114",
            "telephone_number": "309-787-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3724 Blackhawk Road",
            "address_purpose": "LOCATION",
            "city": "Rock Island",
            "state": "IL",
            "postal_code": "612019700",
            "country_code": "US",
            "telephone_number": "309-786-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWEN",
        "first_name": "SUSAN",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.