Provider Demographics
NPI:1962561241
Name:TIMOTHY J MERTES AND MICHAEL D PILLER PARTNERS
Entity type:Organization
Organization Name:TIMOTHY J MERTES AND MICHAEL D PILLER PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:PILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:815-224-8090
Mailing Address - Street 1:2011 ROCK ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-1385
Mailing Address - Country:US
Mailing Address - Phone:815-224-8090
Mailing Address - Fax:815-224-8091
Practice Address - Street 1:2011 ROCK ST
Practice Address - Street 2:SUITE F
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-1385
Practice Address - Country:US
Practice Address - Phone:815-224-8090
Practice Address - Fax:815-224-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Not Answered111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21839Medicare ID - Type UnspecifiedMICHAEL D. PILLER, D.C.
ILU93282Medicare UPIN
IL971460Medicare ID - Type UnspecifiedTIMOTHY J. MERTES, D.C.
ILU87012Medicare UPIN