DR. EDVARD LC GEREGA (NPI# 1356488241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356488241 |
| Entity Type | Individual |
| Full Name | DR. EDVARD LC GEREGA |
| Credential | DC |
| Practice Address |
1013 4th Street Fulton IL 61252-1715 |
| Practice Telephone | 8155893291 |
| Practice Fax Number | 8155893291 |
| Mailing Telephone | 8155893291 |
| Mailing Fax Number | 8155893291 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2010-07-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038006218 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0002906967 | 01 |
| Street Address |
1013 4TH STREET |
| City | FULTON |
| State | IL |
| Zip Code | 61252-1715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043849755 | Journey Well Therapy and Coaching Pllc | Clinic/Center | 408 11th Avenue, Fulton, IL 61252 | 2020-04-04 |
| 1154345551 | Midwest Vision Clinic Plc | Optometrist | 1130 17th Street, Fulton, IL 61252 | 2006-07-27 |
| 1083602031 | Harbor Crest Home Inc | Nursing Facility/Intermediate Care Facility | 817 17th St, Fulton, IL 61252-1020 | 2005-10-12 |
| 1609498245 | Elizabeth Katherine Stoltz | Radiology | 1126 14th Ave, Fulton, IL 61252-1139 | 2020-05-16 |
| 1225523301 | Elizabeth Dimond | Home Health Aide | 822 13th Ave, Fulton, IL 61252-1332 | 2018-06-29 |
| 1871587642 | Tjt Pharmacy, Inc | Pharmacist | 1016 4th St, Fulton, IL 61252-1716 | 2005-09-07 |
| 1346370699 | Terry James Tufty | Pharmacist | 1016 4th St, Fulton, IL 61252-1716 | 2007-03-06 |
| 1851878219 | Ams Holdings, LLC | Chiropractor | 1106 4th Street, Fulton, IL 61252-1718 | 2018-07-27 |
| 1821286394 | Tom M Kao | Chiropractor | 1104 4th St, Fulton, IL 61252-1718 | 2007-10-10 |
| 1801973128 | Cynthia Dawn Treharne | Chiropractor | 1106 4th St, Fulton, IL 61252-1718 | 2006-11-01 |
| Find all providers in zip 61252 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851878219 | Ams Holdings, LLC | Chiropractor | 1106 4th Street, Fulton, IL 61252-1718 | 2018-07-27 |
| 1285155085 | Tri Kim LLC | Chiropractor | 11820 W Market Pl Ste K, Fulton, MD 20759-2421 | 2017-06-30 |
| 1275966715 | Bradley Chiropractic, Pllc | Chiropractor | 432 Lake St, Fulton, KY 42041-1531 | 2013-08-20 |
| 1538505755 | Mallory K Bradley | Chiropractor | 432 Lake St., Fulton, KY 42041 | 2013-05-14 |
| 1740597616 | David L Stuber | Chiropractor | 362 Park Ave, Fulton, NY 13069-2420 | 2010-09-13 |
| 1871731588 | Amy K Green | Chiropractor | 308 Meadowlark Ln, Fulton, MO 65251-2458 | 2009-02-03 |
| 1194985267 | Koelling Family Chiropractic, PC | Chiropractor | 621 Commons Drive, Fulton, MO 65251-2650 | 2008-06-12 |
| 1821286394 | Tom M Kao | Chiropractor | 1104 4th St, Fulton, IL 61252-1718 | 2007-10-10 |
| 1316086804 | Community Chiropractic, P.C. | Chiropractor | 16 Canalview Mall, Fulton, NY 13069-1733 | 2007-02-05 |
| 1528117785 | Brian Hoselton | Chiropractor | 710 S Business 54, Fulton, MO 65251-1403 | 2007-01-09 |
| Find all providers in FULTON | ||||
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| 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.