KANKAKEE VALLEY CHIROPRACTIC (NPI# 1538469655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538469655 |
| Entity Type | Organization |
| Organization Name | KANKAKEE VALLEY CHIROPRACTIC |
| Practice Address |
300 North Kennedy Drive Suite 2 Bradley IL 60915 |
| Practice Telephone | 8159336624 |
| Practice Fax Number | 8159336664 |
| Mailing Telephone | 8159336624 |
| Mailing Fax Number | 8159336664 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |
| Authorized Official Name | DR. BLAKE WILLIAM RANDLES (CEO) |
| Authorized Official Telephone | 8159336624 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038011709 | IL | Chiropractic Providers |
| Street Address |
300 NORTH KENNEDY DRIVE SUITE 2 |
| City | BRADLEY |
| State | IL |
| Zip Code | 60915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1679826309 | Heather Sevier | Specialist/Technologist | 328 S Dearborn Ave, Bradley, IL 60915 | 2012-10-18 |
| 1013266584 | Arlene De Leon Delacruz | Physical Therapist | 400 South Kennedy Dr., Bradley, IL 60915 | 2012-08-30 |
| 1023370699 | Jessica Sorensen | Physician Assistant | 350 N Kinzie Ave, Bradley, IL 60915 | 2012-06-11 |
| 1184993164 | Debra Malone | Behavioral Analyst | 136-142 1/2 South Clinton, Bradley, IL 60915 | 2011-12-21 |
| 1376840421 | Joshua R Johnson | Physician Assistant | 400 S. Kennedy, Bradley, IL 60915 | 2011-02-24 |
| 1801192133 | Eloise Adams | Behavioral Analyst | 136 142 1/2 South Clinton, Bradley, IL 60915 | 2011-02-03 |
| 1386948685 | Rico J Hale | Behavioral Analyst | 136 142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1558665851 | Joyce A Bollhorst | Behavioral Analyst | 136-142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1649442849 | Heidi Kathleen Hynes Nuttall | Physician Assistant | 400 Kennedy Dr, Ste 100, Bradley, IL 60915 | 2008-03-27 |
| Find all providers in zip 60915 | ||||
| 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 |
|---|---|---|---|---|
| 1801994470 | Van Til Chiropractic, Inc. | Chiropractor | 1054 Superior St., Bradley, IL 60915-2150 | 2006-09-20 |
| 1104929769 | Ronald George Nowman | Chiropractor | 300 N Kennedy Drive, 2, Bradley, IL 60915 | 2006-09-07 |
| 1154300812 | Joseph M Mayotte | Chiropractor | 956 W Broadway St, Bradley, IL 60915-2011 | 2006-01-11 |
| 1730184862 | Richard Van Til | Chiropractor | 1054 Superior St, Bradley, IL 60915-2150 | 2005-06-16 |
| 1184078701 | Kline Chiropractic Ltd | Chiropractor | 956 W Broadway St, Bradley, IL 60915-2011 | 2016-04-20 |
| 1679886675 | Blake William Randles | Chiropractor | 300 N Kennedy Dr, Bradley, IL 60915-1559 | 2010-07-19 |
| 1508053422 | David Carl Kline | Chiropractor | 956 W Broadway St, Bradley, IL 60915-2011 | 2007-09-25 |
| 1639392913 | Dr.joseph Mayotte D.c P.c | Chiropractor | 956 W Broadway St, Bradley, IL 60915-2011 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861347 | Evan Charles Mojica | Chiropractor | 1803 W State St Ste 150, Geneva, IL 60134-3692 | 2020-11-06 |
| 1407454424 | Mikel Marshall | Chiropractor | 881 S Lorraine Rd Apt 103, Wheaton, IL 60189-6924 | 2020-10-12 |
| 1912505157 | David Anthony Wesdock | Chiropractor | 208 Parkinson St, Normal, IL 61761-3079 | 2020-10-10 |
| 1902403124 | Maranda Joe Humphreys | Chiropractor | 2150 Manchester Rd Ste 100, Wheaton, IL 60187-2474 | 2020-10-01 |
| 1023625654 | Kennedy Nicole Brauer | Chiropractor | 208 Flax Dr Ste 200, Highland, IL 62249-1394 | 2020-09-28 |
| 1649886730 | Simply Wellness Chiropractic, LLC | Chiropractor | 7117 Crimson Ridge Dr Ste 1, Rockford, IL 61107-6213 | 2020-09-23 |
| 1639785330 | Eve Marie Greenwell | Chiropractor | 143 N Henderson St, Mt Zion, IL 62549-1313 | 2020-09-17 |
| 1588279640 | Guadalupe Garcia | Chiropractor | 2745 Maple Ave Ste 2d, Lisle, IL 60532-3231 | 2020-09-14 |
| 1770197774 | Align Services Bloomington Pllc | Chiropractor | 2309 E Empire St Ste 200a, Bloomington, IL 61704-8636 | 2020-09-07 |
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
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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.