CENTRAL ILLINOIS CHIROPRACTIC, P.C. (NPI# 1558379115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558379115 |
| Entity Type | Organization |
| Organization Name | CENTRAL ILLINOIS CHIROPRACTIC, P.C. |
| Practice Address |
1030 Court St Pekin IL 61554-4806 |
| Practice Telephone | 3093468008 |
| Practice Fax Number | 3093468009 |
| Mailing Telephone | 3093468008 |
| Mailing Fax Number | 3093468009 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2013-02-05 |
| Authorized Official Name | DR. MICHAEL DUANE FUNK (OWNER) |
| Authorized Official Telephone | 3093468008 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 060006218 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 09015695 | 01 |
| Street Address |
1030 COURT ST |
| City | PEKIN |
| State | IL |
| Zip Code | 61554-4806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629478672 | Central Il Chiropractic, Ltd | Chiropractor | 1030 Court St, Pekin, IL 61554-4806 | 2014-08-27 |
| 1326390295 | Jacob Allen Dunker | Chiropractor | 1030 Court St, Pekin, IL 61554-4806 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194279000 | Shauna L Bivens | Nurse Practitioner | 3400 Griffin Ave., Pekin, IL 61554 | 2016-08-09 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1366750671 | Dennis Kammerer Stoller | Dentist | 1608 Broadway, Pekin, IL 61554 | 2010-09-21 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1689856312 | Pekin Supportive Living Limited Patnership | Assisted Living Facility | 1320 Executive Court, Pekin, IL 61554 | 2007-12-05 |
| 1205034824 | Winfield Curtis Morgan | Dentist | 1503 Valle Vista, Pekin, IL 61554 | 2007-07-05 |
| 1376769638 | Debra Mollie Davis | Registered Nurse | 2079 Edgewater Dr, Pekin, IL 61554 | 2007-04-17 |
| 1649308230 | Tazewell County Health Department -dental Health Center | Public Health or Welfare | 135 Radio City Drive, Suite A & B, North Pekin, IL 61554 | 2007-03-02 |
| 1528118239 | Jerry Lee Marshall | Dentist | 135a-b Radio City Drive, North Pekin, IL 61554 | 2007-01-12 |
| Find all providers in zip 61554 | ||||
| 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 |
|---|---|---|---|---|
| 1417299710 | Bednar Chiropractic LLC | Chiropractor | 1113 Court St, Pekin, IL 61554-4921 | 2013-03-25 |
| 1720349780 | Neal Family Chiropractic PC | Chiropractor | 2978 Court St., Pekin, IL 61554 | 2012-06-06 |
| 1558584375 | Michele Moul | Chiropractor | 1331 El Camino Dr, Pekin, IL 61554-6501 | 2007-04-10 |
| 1245389741 | Dale Harrison | Chiropractor | 924 S 10th St, Pekin, IL 61554-4811 | 2007-01-10 |
| 1992713101 | Todd H Clanahan | Chiropractor | 105 N Parkway Dr, Pekin, IL 61554-3932 | 2006-08-03 |
| 1659389211 | Michael Duane Funk | Chiropractor | 1030 Court Street, Pekin, IL 61554-4806 | 2006-08-03 |
| 1063434603 | Jerry B Witt | Chiropractor | 611 Margaret St, Pekin, IL 61554-3355 | 2006-07-24 |
| 1851346357 | Gerald Depew | Chiropractor | 3299 Court St, Pekin, IL 61554-6208 | 2006-05-23 |
| 1457320293 | Richard Joseph Martis | Chiropractor | 1340 Park Ave, Pekin, IL 61554 | 2006-03-15 |
| 1700862315 | Aaron Albert Stein | Chiropractor | 800 Derby St, Pekin, IL 61554-5847 | 2005-12-16 |
| Find all providers in PEKIN | ||||
Please comment or provide details below to improve the information on CENTRAL ILLINOIS CHIROPRACTIC, P.C..
| 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.