PRO-ACTIVE HEALTH CHIROPRACTIC L.L.C. (NPI# 1124290630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124290630 |
| Entity Type | Organization |
| Organization Name | PRO-ACTIVE HEALTH CHIROPRACTIC L.L.C. |
| Practice Address |
3537 Archer Dr East Moline IL 61244-3719 |
| Practice Telephone | 3097912436 |
| Mailing Telephone | 3097912436 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-09-05 |
| Authorized Official Name | DR. CALLYN ROSE DITTMAR (CHIROPRACTOR) |
| Authorized Official Telephone | 3097912436 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 038011137 | IL | Ambulatory Health Care Facilities |
| Street Address |
3537 ARCHER DR |
| City | EAST MOLINE |
| State | IL |
| Zip Code | 61244-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669642500 | Callyn Rose Dittmar | Chiropractor | 3537 Archer Dr, East Moline, IL 61244-3719 | 2008-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457870917 | Sara Winders | Speech-Language Pathologist | 3451 Morton Drive, East Moline School District #37, East Moline, IL 61244 | 2017-09-15 |
| 1962888735 | Kathryn Miller | Occupational Therapist | 3909 5th Street, East, IL 61244 | 2015-08-04 |
| 1194035782 | Polly Anne Haskins | Nurse Practitioner | 465 Avenue of The Cities, Suite 100, East Moline, IL 61244 | 2010-10-15 |
| 1083843171 | Shannon A. Scott | Private Vehicle | 170 15th Ave, East Moline, IL 61244 | 2009-07-09 |
| 1538203575 | Kory M Melin | Dentist | 2909 19th Street, East Moline, IL 61244 | 2007-02-15 |
| 1497766893 | John J Naert | Dentist | 401 Avenue of The Cities, East Moline, IL 61244 | 2006-08-10 |
| 1538115928 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 107 Avenue of The Cities, East Moline, IL 61244 | 2006-05-26 |
| 1538135744 | Stephen Edward Matheis | Chiropractor | 2819 19th St, East Moline, IL 61244 | 2006-02-27 |
| 1154307965 | Family Chiropractic of The Quad Cities Ltd | Chiropractor | 640 15th Ave, East Moline, IL 61244 | 2005-12-22 |
| 1295242063 | Ann Patrice Morey | Speech-Language Pathologist | 1275 Avenue of The Cities, East Moline, IL 61244 | 2018-01-03 |
| Find all providers in zip 61244 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356640346 | Tri-county Alcohol and Drug Services LLC | Clinic/Center | 926 15th Ave, East Moline, IL 61244-2138 | 2011-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| City | EAST MOLINE |
| Zip Code | 61244 |
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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.