Individual provider Active NPI

Timothy L Wenneborg, DC

  • Chiropractor
  • Springfield, IL
National Provider Identifier
1821089780
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
1045 S 2ND St
Springfield, IL 62704-3004
Phone
(207) 544-5213
Fax
(217) 544-8792
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

1045 S 2ND St
Springfield, IL 62704-3004

Mailing address

1045 S 2ND St
Springfield, IL 62704-3004
Phone (207) 544-5213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120419000220 IL Practitioner - Chiropractic 0941461958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1045 S 2ND St
Springfield, IL 62704-3004
Phone (217) 544-5213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-006564ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Chiropractic Clinic LTD CurrentSince Jan 1, 1993 Accepting new patients
Unverzagt Family Chiropractic, LTD. Chiropractor PastSince Jul 28, 2017 Accepting new patients

Locations

1045 S 2nd St
Springfield, IL 62704
Phone (217) 544-3628

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821089780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 S 2ND ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043004",
            "telephone_number": "207-544-5213",
            "fax_number": "217-544-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 S 2ND ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043004",
            "telephone_number": "207-544-5213",
            "fax_number": "217-544-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNEBORG",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.