Roberto Ulloa Jr., DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

115414 Issued in IA

Practice address

515 18TH Ave
East Moline, IL 61244-2037

Phone

(619) 410-1406

NPI assigned

Dec 23, 2022

Last updated

Dec 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1811609688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 EAGLE RIDGE RD",
            "city": "LE CLAIRE",
            "state": "IA",
            "postal_code": "527539593",
            "telephone_number": "563-289-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 18TH AVE",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442037",
            "telephone_number": "619-410-1406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Eagle Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Le Claire",
            "state": "IA",
            "postal_code": "527539593",
            "country_code": "US",
            "telephone_number": "563-289-3242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "115414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drulloa222@gmail.com",
            "affiliation": "N",
            "address_1": "700 Eagle Ridge Rd",
            "city": "Le Claire",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527539593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Chiropractor in East Moline, IL
• Providers in East Moline, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.