DR. MICHAEL L LARSEN (NPI# 1619053931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619053931 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL L LARSEN |
| Credential | DC |
| Practice Address |
1052 E Losey St Galesburg IL 61401-3874 |
| Practice Telephone | 3093422777 |
| Practice Fax Number | 3093426702 |
| Mailing Telephone | 3093422777 |
| Mailing Fax Number | 3093426702 |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038006092 | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 350015512 | 01 | |
| IL | 038006092 | 05 | |
| IL | BLUE CROSS BLUE SHIELD | 0004882015 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134508039 | Michael Larsen | Radiologic Technologist | 11019 Dove Tail Ter, San Diego, CA 92128-4019 | 2015-05-25 |
| 1891999264 | Michael E Larsen | Social Worker | 24620 Knox Dr, Marshall, MO 65340-4304 | 2007-06-12 |
| 1558415745 | Michael Paul Larsen | Optometrist | 59 Auburn St, Auburn, MA 01501-2428 | 2007-01-23 |
| 1144383308 | Michael Richard Larsen | Chiropractor | 201 Allegheny Ave, Coudersport, PA 16915-1501 | 2006-12-19 |
| 1376570242 | Michael Andrew Larsen | Dentist | 1361 E 16th St, Burley, ID 83318-2008 | 2006-06-27 |
| 1144781717 | Michael Larsen | Anesthesiology | 5841 S. Maryland Ave, M/c 4028, Chicago, IL 60637-1443 | 2019-03-27 |
| 1114391851 | Michael Larsen | Physician Assistant | 55 Coburg Rd, Eugene, OR 97401-2433 | 2015-11-18 |
| 1891040440 | Michael Thorpe Larsen | Plastic Surgery | 370 E Virginia Ave Ste 100, Phoenix, AZ 85004-1254 | 2012-07-19 |
| 1962685222 | Michael Carl Larsen | Internal Medicine | 1100 9th Ave, Seattle, WA 98101-2756 | 2007-12-10 |
| 1902005663 | Michael L Larsen | Radiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2007-07-13 |
| Street Address |
1052 E LOSEY ST |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401-3874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| Find all providers in zip 61401 | ||||
| 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 |
|---|---|---|---|---|
| 1255813770 | Galesburg Wellness Systems P.C. | Chiropractor | 575 N Kellogg St Ste 2, Galesburg, IL 61401-7609 | 2018-08-31 |
| 1902096647 | Charles E Fandel | Chiropractor | 1580 E Knox St, Galesburg, IL 61401-5300 | 2007-07-30 |
| 1922120948 | Jeffrey Lee Hayden | Chiropractor | 1174 N Seminary St, Galesburg, IL 61401-2858 | 2007-04-03 |
| 1205939014 | Jeffery James Wilson | Chiropractor | 1128 Monroe St, Galesburg, IL 61401-2523 | 2006-09-07 |
| 1003928508 | Thomas Michael Kovacik | Chiropractor | 1128 Monroe Street, Galesburg, IL 61401-2542 | 2006-08-31 |
| 1831202472 | Patricia Ann Osborne-kirkemo | Chiropractor | 311 E Main St Ste 417, Galesburg, IL 61401-4867 | 2006-08-17 |
| 1598723546 | Luke N Sakalosky | Chiropractor | 444 N Henderson St, Galesburg, IL 61401-3508 | 2006-05-01 |
| 1083671762 | Eugene E Peck | Chiropractor | 777 N Henderson St, Galesburg, IL 61401 | 2006-04-27 |
| 1972500643 | Brian Christopher Buelt | Chiropractor | 672 W Main St, Galesburg, IL 61401-3549 | 2005-07-07 |
| 1619236221 | Knox County Chiropractic Clinic | Chiropractor | 1128 Monroe St, Galesburg, IL 61401 | 2012-05-16 |
| Find all providers in GALESBURG | ||||
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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.