MEDICARE: VAN TIL CHIROPRACTIC, PC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038.010127	IL

General Provider Information

NPI Number	:	1801994470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN TIL CHIROPRACTIC, PC.

Provider Business Mailing Address
First Line	:	404 S KENNEDY DR
Second Line	:
City	:	BRADLEY
State	:	IL
Zip	:	60915-2137
Country	:	US
Telephone Number	:	815-929-9296
Fax Number	:	815-929-9667

Provider Business Practice Location Address
First Line	:	404 S KENNEDY DR
Second Line	:
City	:	BRADLEY
State	:	IL
Zip	:	60915-2137
Country	:	US
Telephone Number	:	815-929-9296
Fax Number	:	815-929-9667

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD CALVIN VAN TIL
Credential	:	D.C.
Telephone Number	:	815-929-9296

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/02/2025

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