NPIMap

Organization Active NPI

Chiromed LTD

  • Chiropractor
  • Belleville, IL
National Provider Identifier
1962403907
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROMED LTD
Practice address
3200 West Main St Reet
Belleville, IL 62226
Phone
(618) 235-3200
Fax
(618) 235-3282
NPI assigned
Aug 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Dr. Benjamin Joshua Laux Sr., D.C.
Title
Clinic Owner
Phone
(618) 235-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

3200 West Main St Reet
Belleville, IL 62226

Mailing address

3200 West Main St Reet
Belleville, IL 62226
Phone (618) 235-3200

Other names 1

  • ChiroMed LTD DBA Dueker HealthClinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120328000828 IL Part B Supplier - Clinic/Group Practice 2668632621 Receives reassigned benefits from 1 practitioner
Practice locations: Belleville, IL

National Provider Directory

National Provider Directory
Tax ID family
Chirom-Med LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2900 Frank Scott Pkwy W
Ste 904
Belleville, IL 62223
Phone (618) 234-0640

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1962403907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 WEST MAIN ST REET",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-235-3200",
            "fax_number": "618-235-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 WEST MAIN ST REET",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-235-3200",
            "fax_number": "618-235-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROMED LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-01",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "LAUX",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JOSHUA",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "618-235-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChiroMed LTD DBA Dueker HealthClinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.