D. Tyler Dennison, D.C,
Individual provider Active NPI Chiropractor · Harrisburg, IL
NPI 1962711085 · NPPES record last updated Mar 28, 2012
Key facts
- NPI
- 1962711085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038011782 (IL)
- Practice address
- 303 S Commercial St Ste 10
Harrisburg, IL 62946-2125 - Phone
- (618) 252-5555
- Fax
- (618) 252-2279
- NPI assigned
- Oct 7, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrated Health of Southern Illinois LTD
Practice addresses (Care Compare)
303 S Commercial St
Suite 10
Harrisburg, IL 62946-2125
Phone (618) 252-5555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101201000398 | IL | Practitioner - Chiropractic | 4385830439 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Health of Southern Illinois, LTD. | Chiropractor | Current |
Accepting new patients |
| Integrated Health of Southern Illinois | Chiropractor | Current |
Accepting new patients |
Locations
310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719
303 S Commercial St
Ste 10
Harrisburg, IL 62946
Phone (618) 252-5555
Interoperability endpoints
- https://api.platform.athenahealth.com/26231/brand/1/csg/1/fhir/r4
- damien.dennison.1@26231.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038011782 | IL | Yes |
Addresses
Primary practice location
303 S Commercial St Ste 10
Harrisburg, IL 62946-2125
Mailing address
303 S Commercial St Ste 10
Harrisburg, IL 62946-2125
Phone (618) 252-5555
Other providers in Harrisburg, IL
- Deaconess Illinois Clinic, Inc
- Deaconess Illinois Specialty Clinic, Inc.
- Deaconess Illinois Specialty Clinic, Inc.
- Deaconess Regional Healthcare Services Illinois Inc
- Leanne H Deneal
- Moises B. Domingo
- Dr. Michael J. Gearing D.D.S. Inc
- Egyptian Health Department
- Egyptian Health Department
- Egyptian Health Department
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.