Individual provider Active NPI

Dale Lynn Wohlrabe, D.C.

  • Chiropractor
  • Springfield, IL
National Provider Identifier
1881610509
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011817 Issued in IL
Practice address
2700 W Lawrence Ave
Suite J-4
Springfield, IL 62704-1181
Phone
(271) 546-6698
Fax
(217) 546-4487
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1935 MN
Chiropractor 111N00000X 038.011817 IL Primary

Addresses

Primary practice location

2700 W Lawrence Ave
Suite J-4
Springfield, IL 62704-1181

Mailing address

2700 W Lawrence Ave
Suite J-4
Springfield, IL 62704-1181
Phone (271) 546-6698

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
038.011817ILMDChiropractor
1935MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
GNR Chiropractic LLC Chiropractor PastSince Mar 1, 2018 Accepting new patients

Organizations & group practices 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1881610509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W LAWRENCE AVE",
            "address_2": "SUITE J-4",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041181",
            "telephone_number": "271-546-6698",
            "fax_number": "217-546-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W LAWRENCE AVE",
            "address_2": "SUITE J-4",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041181",
            "telephone_number": "271-546-6698",
            "fax_number": "217-546-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOHLRABE",
        "first_name": "DALE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1935",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011817",
            "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 Aug 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.