Individual provider Active NPI

Mark Allen Sloan, D.C.

  • Chiropractor
  • Loves Park, IL
National Provider Identifier
1033168307
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008006 Issued in IL
Practice address
1820 Windsor Rd
Loves Park, IL 61111-4271
Phone
(779) 423-1700
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2682 NC
Chiropractor 111N00000X 038008006 IL Primary

Addresses

Primary practice location

1820 Windsor Rd
Loves Park, IL 61111-4271

Mailing address

1820 Windsor Rd
Loves Park, IL 61111-4271
Phone (779) 423-1700

Other identifiers 2

IdentifierTypeStateIssuer
890838AMedicaidNC
890938AMedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419002107 IN Practitioner - Chiropractic 9739122011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2682NCMDClinical Psychologist
038008006ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ipm Service Company LLC Chiropractor Current Accepting new patients
West 84TH Drive Chiropractic PC Chiropractor CurrentSince Mar 9, 2022 Accepting new patients
Carolina Chiropractic Consultants, Inc 8 Chiropractor Past Accepting new patients
Wellness One of Hickory, Inc. Chiropractor Past Accepting new patients
Atlas Chiropractic Health Center, Inc. Past Accepting new patients

Locations

100 W 84th Dr
Merrillville, IN 46410
Phone (219) 736-7363

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1033168307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 WINDSOR RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114271",
            "telephone_number": "779-423-1700",
            "fax_number": "708-895-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 WINDSOR RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114271",
            "telephone_number": "779-423-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2682",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890838A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890938A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.