Reich Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038006052 Issued in IL

Legal business name

REICH CHIROPRACTIC CLINIC PC

Practice address

1831 Blackhawk Blvd
South Beloit, IL 61080-2499

Phone

(815) 389-1492

Fax

(815) 389-1495

NPI assigned

Nov 15, 2005

Last updated

Mar 18, 2015By 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. Bradley J Reich, DC

Title

President

Phone

(815) 389-1492

Specialties & licenses 2

Addresses

Other names 1

• Dr Bradley J Reich Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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.

• Jillian Rose Mazeika, CHIROPRACTOR

  • Chiropractor
  • South Beloit, IL
  • NPI 1477159341
  Medicare reassignment NPD

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1891777082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 BLACKHAWK BLVD",
            "city": "SOUTH BELOIT",
            "state": "IL",
            "postal_code": "610802499",
            "telephone_number": "815-389-1492",
            "fax_number": "815-389-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 BLACKHAWK BLVD",
            "city": "SOUTH BELOIT",
            "state": "IL",
            "postal_code": "610802499",
            "telephone_number": "815-389-1492",
            "fax_number": "815-389-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REICH CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "REICH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-389-1492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006052",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3400012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Bradley J Reich",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Thuy T Nguyen, DO
• Jessica A Ortega
• Kara Phillips
• Prairie Hill CCSD 133
• Joseph C Probst, DC
• Teresa Ann Sambrook, RN
• Nicole M Simpson, N.P.
• Catherine Jean Smith, M.A., CF-SLP
• Michelle Kay Smith, P.T.A.
• South Beloit Office

• Chiropractor in South Beloit, IL
• Providers in South Beloit, 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, 2015; 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.