DR. JONATHAN WILLIAM BULLOCK (D.C.) – Chiropractor, NPI 1114015815

DR. JONATHAN WILLIAM BULLOCK (D.C.) is a healthcare provider. based in Mokena, Illinois. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 038-009659 (IL). The NPI Number for DR. JONATHAN WILLIAM BULLOCK (D.C.) is 1114015815

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. JONATHAN WILLIAM BULLOCK (D.C.)
NPI
1114015815
Phone
(708) 478-3000
Address
19600 LA GRANGE RD
Enumeration Date
10 October 2006
Last Update Date
13 November 2024

Doctor Profile

Medical School Name
PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Secondary Phone
7084783000
Graduation Year
2002 (24 years ago)
PAC ID
9335166750
Group Practice PAC ID
8729050489
Professional Enrollment ID
I20051025000958
Address ID
IL604489321MO19600RDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,145 CHIROPRACTIC in IL

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Provider Addresses for DR. JONATHAN WILLIAM BULLOCK (D.C.)

  • 19600, South La Grange Road, Mokena, Will County, Illinois, 60448, United States

    MOKENA, IL 604489321

    Phone: (708) 478-3000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-10-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051025000958IChiropracticILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60448)

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Provider's Procedures

DR. JONATHAN WILLIAM BULLOCK (D.C.) performs procedures in CHIROPRACTIC. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CHIROPRACTICIL98940Chiropractic manipulative treatment, 1-2 spinal regions45838

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729050489View full group profile
NameSpecialtyState
C H I R O P R A C T I CIL
C H I R O P R A C T I CIL
-IL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

How do payers reference DR. JONATHAN WILLIAM BULLOCK (D.C.)?
For DR. JONATHAN WILLIAM BULLOCK (D.C.), use NPI 1114015815 as the unique 10-digit identifier.
Is DR. JONATHAN WILLIAM BULLOCK (D.C.) shown as active in public data?
Registry records indicate DR. JONATHAN WILLIAM BULLOCK (D.C.) maintains an active NPI.
What clinical focus is listed for DR. JONATHAN WILLIAM BULLOCK (D.C.)?
At a glance, DR. JONATHAN WILLIAM BULLOCK (D.C.) is tied to Chiropractor. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. JONATHAN WILLIAM BULLOCK (D.C.)?
Directory geography for DR. JONATHAN WILLIAM BULLOCK (D.C.) centers on Mokena, Illinois.
Can I trust this NPI listing for DR. JONATHAN WILLIAM BULLOCK (D.C.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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