ACUPUNCTURE & CHIROPRACTIC CENTER (NPI# 1336417724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336417724 |
Entity Type | Organization |
Organization Name | ACUPUNCTURE & CHIROPRACTIC CENTER |
Practice Address |
716 S 2nd St Springfield IL 62704-2516 |
Practice Telephone | 2175448118 |
Enumeration Date | 2011-12-13 |
Last Update Date | 2011-12-13 |
Authorized Official Name | DR. LOUIS T DISTASIO (OWNER) |
Authorized Official Telephone | 2175448118 |
Authorized Official Credential | D.C. L.AC. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
198000025 | IL | Ambulatory Health Care Facilities |
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
038003935 | IL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS BLUE SHIELD | 8482034 | 01 |
Street Address |
716 S 2ND ST |
City | SPRINGFIELD |
State | IL |
Zip Code | 62704-2516 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508310533 | Terry Frank | Acupuncturist | 716 S 2nd St, Springfield, IL 62704-2516 | 2016-08-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
Find all providers in zip 62704 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
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1962644807 | Hshs Medical Group Inc | Clinic/Center | 3051 Hollis Dr, Springfield, IL 62704-7450 | 2009-03-24 |
1508835893 | Banyan Group, Inc. | Clinic/Center | 3805 S Kansas Expy, Springfield, MO 65807-6988 | 2006-03-17 |
1568017481 | Memorial Medical Center | Clinic/Center | 701 N 1st St, Springfield, IL 62781-0001 | 2019-08-07 |
1972030740 | Mayo Clinic Health System-southwest Minnesota Region | Clinic/Center | 625 N Jackson Ave, Springfield, MN 56087-1714 | 2017-05-11 |
1386661148 | Springfield Medical Associates, Inc | Clinic/Center | 2150 Main St, Springfield, MA 01104-3300 | 2006-07-17 |
1740223874 | Peacehealth | Clinic/Center | 3377 Riverbend Dr, Springfield, OR 97477-8803 | 2006-06-14 |
1215974415 | Springfield Clinic LLP | Clinic/Center | 1025 S 6th St, Springfield, IL 62703-2403 | 2006-05-31 |
1780638478 | Springfield Clinic, LLP | Clinic/Center | 1025 S 6th St, Springfield, IL 62703-2403 | 2006-05-19 |
1326099383 | Ferrell Duncan Clinic, Inc | Clinic/Center | 1001 E Primrose St, Springfield, MO 65807-5155 | 2006-05-15 |
1417922964 | Memorial Physician Services | Clinic/Center | 701 N 1st St, Springfield, IL 62781-0001 | 2006-02-20 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 62704 |
Please comment or provide details below to improve the information on ACUPUNCTURE & CHIROPRACTIC CENTER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.