Jeanne E. McWilliams, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038003521 Issued in IL

Practice address

2001 52ND Ave
Suite 1
Moline, IL 61265

Phone

(309) 764-4901

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Jeanne E. Black Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1831144286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 52ND AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "309-764-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 52ND AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "309-764-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "JEANNE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05270",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038003521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0008115279",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038003521",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "BLACK",
            "middle_name": "E.",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.