Organization Active NPI

Evolve Chiropractic PLLC

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1013389014
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011574 Issued in IL
Legal business name
EVOLVE CHIROPRACTIC PLLC
Practice address
451 Dunham Rd
Suite G
St Charles, IL 60174-1431
Phone
(224) 250-3526
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Dr. Scott Cruse, DC
Title
Owner
Phone
(224) 250-3526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038011574 IL Primary

Addresses

Primary practice location

451 Dunham Rd
Suite G
St Charles, IL 60174-1431

Mailing address

451 Dunham Rd
Suite G
St Charles, IL 60174-1431
Phone (224) 250-3526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151202002703 IL Part B Supplier - Clinic/Group Practice 0941500664 Receives reassigned benefits from 4 practitioners
Practice locations: St Charles, IL

National Provider Directory

National Provider Directory

Locations

451 Dunham Rd
Ste 700
St Charles, IL 60174
Phone (630) 549-6474

451 Dunham Rd
Ste G
St Charles, IL 60174
Phone (224) 250-3526

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1013389014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 DUNHAM RD",
            "address_2": "SUITE G",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741431",
            "telephone_number": "224-250-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 DUNHAM RD",
            "address_2": "SUITE G",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741431",
            "telephone_number": "224-250-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "CRUSE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-250-3526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.