Individual provider Active NPI

Vanessa Prado

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1033790977
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013692 Issued in IL
Practice address
4711 N Broadway St Ste 103
Chicago, IL 60640-4908
Phone
(773) 820-7580
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013692 IL Primary

Addresses

Primary practice location

4711 N Broadway St Ste 103
Chicago, IL 60640-4908

Mailing address

3337 N Avers Ave
Chicago, IL 60618-5203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
038013692ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Remedy Alternative Care Clinic LLC Chiropractor CurrentSince Dec 10, 2023 Accepting new patients

Locations

4711 N Broadway St
Ste 103
Chicago, IL 60640
Phone (312) 344-3559

Organizations & group practices 1

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1033790977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3337 N AVERS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 N BROADWAY ST STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404908",
            "telephone_number": "773-820-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADO",
        "first_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.