Alexis Kaye Black, DC is a medicare enrolled "Chiropractor" provider in Streator, Illinois. Her current practice location is
1355 E 19th Rd, Streator, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 257-5394.
Alexis Kaye Black is licensed to practice in Illinois (license number 038.014184) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669294526.
Healthcare Provider's Profile
| Full Name | Alexis Kaye Black |
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| Gender | Female |
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| Speciality | Chiropractor |
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| Location | 1355 E 19th Rd, Streator, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669294526
- Provider Enumeration Date: 10/30/2024
- Last Update Date: 04/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 5597293233
- Enrollment ID: I20250109000986
Medical Identifiers
Medical identifiers for Alexis Kaye Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669294526 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111NI0013X | Chiropractor - Independent Medical Examiner | 038.014184 (Illinois) | Secondary |
| 111N00000X | Chiropractor | 038.014184 (Illinois) | Primary |
| 111NI0900X | Chiropractor - Internist | 038.014184 (Illinois) | Secondary |
| 111NN0400X | Chiropractor - Neurology | 038.014184 (Illinois) | Secondary |
| 111NR0200X | Chiropractor - Radiology | 038.014184 (Illinois) | Secondary |
| 111NN1001X | Chiropractor - Nutrition | 038.014184 (Illinois) | Secondary |
| 111NP0017X | Chiropractor - Pediatric Chiropractor | 038.014184 (Illinois) | Secondary |
| 111NR0400X | Chiropractor - Rehabilitation | 038.014184 (Illinois) | Secondary |
| 111NX0100X | Chiropractor - Occupational Health | 038.014184 (Illinois) | Secondary |
| 111NX0800X | Chiropractor - Orthopedic | 038.014184 (Illinois) | Secondary |
| 111NS0005X | Chiropractor - Sports Physician | 038.014184 (Illinois) | Secondary |
| 111NT0100X | Chiropractor - Thermography | 038.014184 (Illinois) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alexis Kaye Black allows following entities to bill medicare on her behalf.
| Provider Name | Bartoli Chiropractic Center, Ltd |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1306971718
PECOS PAC ID: 6204930506
Enrollment ID: O20070327000032 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alexis Kaye Black is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Alexis Kaye Black, DC
301 Lextin Dr,
Streator, IL 61364-9316
Ph: (815) 257-5394 | Alexis Kaye Black, DC
1355 E 19th Rd,
Streator, IL 61364-9743
Ph: (815) 257-5394 |
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