Kim Arthur Wickwire, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

3706 N Faber Ave
Peoria Heights, IL 61616-7614

Phone

(309) 685-6910

Fax

(309) 685-7313

NPI assigned

Jan 8, 2007

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

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1978

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871641993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 N FABER AVE",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167614",
            "telephone_number": "309-685-6910",
            "fax_number": "309-685-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 N FABER AVE",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167614",
            "telephone_number": "309-685-6910",
            "fax_number": "309-685-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKWIRE",
        "first_name": "KIM",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Village of Peoria Heights (Peoria Heights Ambulance Service)
• Caitlyn Clare Wagenbach, PA-C
• Walgreen Co (Walgreens #05544)
• Stephanie K Weir, LCPC
• Jeffrey Scott Whitson, DMD
• Katherine Sue Wiekert, RPH
• Sheila Renea Wilson, PERSONAL ASSISTANT
• Jessica Lynn Wooden, LCSW

• Chiropractor in Peoria Heights, IL
• Providers in Peoria Heights, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.