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DR. KEVIN DANIEL DEROUEN DC
NPI 1093674228
Chiropractor in Bradley, IL

Active since January 22, 2026Accepts Medicare Assignment
404 S KENNEDY DR, BRADLEY, IL 60915(815) 929-9296 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kevin Daniel Derouen Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN DANIEL DEROUEN DC (NPI 1093674228) is an individual chiropractor in Bradley, Illinois, licensed in Illinois (038.014421) and active in the NPI registry since January 2026. He is a graduate of Logan College Of Chiropractic (2025).

NPPES Registry Identity

NPI1093674228
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. KEVIN DANIEL DEROUENCredential: DC
Location Address404 S KENNEDY DRBradley, IL 60915-2137
Mailing Address204 S Oppyville RdWatseka, IL 60970-7911 · (757) 254-2999
Phone(815) 929-9296
Sole ProprietorNo
Medical School CMSLogan College Of ChiropracticGraduated 2025
Enumeration DateJanuary 22, 2026
NPPES CertifiedJanuary 22, 2026
✔ NPI 1093674228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038.014421
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
404 S KENNEDY DR, Bradley, IL 60915
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Daniel Derouen Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698256394
PECOS Enrollment IDI20260220001602

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RICHARD VAN TIL D.C.
Chiropractor
404 S KENNEDY DR
BRADLEY, IL 60915
Kankakee County (815) 929-9296
VAN TIL CHIROPRACTIC, PC.
Chiropractor
404 S KENNEDY DR
BRADLEY, IL 60915
Kankakee County (815) 929-9296

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Derouen's NPI number?

The NPI number for Kevin Derouen is 1093674228. It was assigned to this individual provider in the NPPES registry on January 22, 2026.

Where is Kevin Derouen located?

Kevin Derouen practices at 404 S Kennedy Dr, Bradley, IL 60915. The listed phone number is (815) 929-9296.

What is Kevin Derouen's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kevin Derouen enrolled in Medicare?

Yes. Kevin Derouen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kevin Derouen was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.