Sam K Chin, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038004241 Issued in IL

Practice address

611 Auburn St.
Rockford, IL 61103-4710

Phone

(815) 962-6363

NPI assigned

Dec 14, 2006

Last updated

Mar 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1013079540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W. HIGGINS RD.",
            "address_2": "SUITE 202",
            "city": "HOFFMAN ESTATE",
            "state": "IL",
            "postal_code": "601692428",
            "telephone_number": "847-882-9191",
            "fax_number": "847-382-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 AUBURN ST.",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034710",
            "telephone_number": "815-962-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "SAM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01682287",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamolchanok Deer Cheung, PHARMD
• Gabrielle Chevance, D.M.D
• Children's Home & Aid Society of America
• Children's Home and Aid
• Nagalakshmi Neeraja Chimpudi, DO
• Chiro One Wellness Center of Rockford LLC
• Chiropractic First of Rockford
• Solab Chitrakar, MD
• Michael J Chmell, M.D.
• Samira Mahbub Choudhury, LPC

• Chiropractor in Rockford, IL
• Providers in Rockford, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.