Organization Active NPI

Healthsource of Plainfield LTD

  • Chiropractor
  • Plainfield, IL
National Provider Identifier
1881845691
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-011006 Issued in IL
Legal business name
HEALTHSOURCE OF PLAINFIELD LTD
Practice address
24020 W Riverwalk CT
Suite 118
Plainfield, IL 60544-7103
Phone
(815) 782-7097
Fax
(815) 782-7167
NPI assigned
Oct 10, 2008
Last updated
May 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Authorized official

Name
Dr. Jennifer Kay Breuer-Harej, D.C.NPI 1568609691
Title
President
Phone
(319) 850-1512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-011006 IL Primary

Addresses

Primary practice location

24020 W Riverwalk CT
Suite 118
Plainfield, IL 60544-7103

Mailing address

24020 W Riverwalk CT
Suite 118
Plainfield, IL 60544-7103
Phone (815) 782-7097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090312000342 IL Part B Supplier - Clinic/Group Practice 0547326753 Receives reassigned benefits from 2 practitioners
Practice locations: Plainfield, IL

National Provider Directory

National Provider Directory

Locations

24020 W Riverwalk Ct
Ste 116
Plainfield, IL 60544
Phone (815) 782-7097

24020 W Riverwalk Ct
Ste 118
Plainfield, IL 60544
Phone (815) 782-7097

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398902400000",
    "number": "1881845691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24020 W RIVERWALK CT",
            "address_2": "SUITE 118",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605447103",
            "telephone_number": "815-782-7097",
            "fax_number": "815-782-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24020 W RIVERWALK CT",
            "address_2": "SUITE 118",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605447103",
            "telephone_number": "815-782-7097",
            "fax_number": "815-782-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF PLAINFIELD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2014-05-01",
        "status": "A",
        "authorized_official_last_name": "BREUER-HAREJ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-850-1512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; 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.