Southern Illinois Spine & Joint Center of Marissa LLC
NPI 1053664557ActiveOrganization· Chiropractor· Marissa, IL
Chiropractor in Marissa, Illinois, registered in NPPES in October 2012. The authorized official on file is Ryan Reiss, D.C., Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053664557 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 22, 2012 |
| Last updated in NPPES | Dec 12, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 038011854 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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