Springfield Chiropractic Clinic LTD

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

042007918 Issued in IL

Legal business name

SPRINGFIELD CHIROPRACTIC CLINIC LTD

Doing business as

Springfield Spinal Rehab

Practice address

1045 S 2ND St
Springfield, IL 62704-3004

Phone

(217) 544-5213

Fax

(217) 544-8792

NPI assigned

Mar 13, 2007

Last updated

Apr 16, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy L Wenneborg, D.C.NPI 1821089780

Title

Administrator

Phone

(217) 544-5213

Specialties & licenses 1

Addresses

Other names 1

• Springfield Spinal Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy L Wenneborg, DC

  • Chiropractor
  • Springfield, IL
  • NPI 1821089780
  Medicare reassignment NPD Authorized official
• Kimberly Anne Biggs, LMT

  • Massage Therapist
  • Springfield, IL
  • NPI 1215360839
  NPD (past)
• Stephen Christopher Unverzagt, D.C.

  • Chiropractor
  • Springfield, IL
  • NPI 1710145032
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1881727642",
    "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": "217-544-5213",
            "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": "217-544-5213",
            "fax_number": "217-544-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD CHIROPRACTIC CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "WENNEBORG",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "217-544-5213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "042007918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Spinal Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Springfield Area Ambulance, Inc.
• Springfield Associates in Oral & Maxillofacial Surgery LTD
• Springfield Care Center, LLC (Aperion Care Springfield)
• Springfield Care Center, LLC (Aperion Care Springfield)
• Springfield Catholic Charities
• Springfield Clinic 1St Laboratory
• Springfield Clinic Health Services LLC (Springfield Clinic, LLP)
• Springfield Clinic Hematology Oncology Lab
• Springfield Clinic LLP
• Springfield Clinic LLP

• Rehabilitation Chiropractor in Springfield, IL
• Providers in Springfield, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.