Individual provider Active NPI

Kenneth Wayne Pitkin, DC

  • Chiropractor
  • Dixon, IL
National Provider Identifier
1952368227
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007454 Issued in IL
Practice address
101 W 2ND St
Ste 150
Dixon, IL 61021
Phone
(815) 288-7911
Fax
(815) 288-6387
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038007454 IL Primary

Addresses

Primary practice location

101 W 2ND St
Ste 150
Dixon, IL 61021

Mailing address

101 W 2ND St
Ste 207
Dixon, IL 61021-3050
Phone (815) 288-7911

Other identifiers 2

IdentifierTypeStateIssuer
38007454MedicaidIL
05227552OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111114000146 IL Practitioner - Chiropractic 8022282839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 W 2ND St
Suite 207
Dixon, IL 61021-3050
Phone (815) 288-7911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038007454ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pitkin Family Chiropractic Inc. Chiropractor CurrentSince Jun 1, 2001 Accepting new patients

Locations

101 W 2nd St
Ste 207
Dixon, IL 61021
Phone (815) 288-7911

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952368227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "address_2": "STE 207",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213050",
            "telephone_number": "815-288-7911",
            "fax_number": "815-288-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "address_2": "STE 150",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-288-7911",
            "fax_number": "815-288-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITKIN",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38007454",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05227552",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.