Individual provider Active NPI

Simone Washington, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1043591217
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-011451 Issued in IL
Practice address
4030 N. Cicero
Chicago, IL 60641-1807
Phone
(773) 557-7766
Fax
(773) 557-7767
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-011451 IL Primary

Addresses

Primary practice location

4030 N. Cicero
Chicago, IL 60641-1807

Mailing address

PO Box 5977
Dept 203052
Carol Stream, IL 60197-5977
Phone (630) 754-8788

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

State licenses

LicenseStateTypeSpecialty
038-011451ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center Metro of Old Irving LLC Chiropractor Past Accepting new patients

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": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1043591217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5977",
            "address_2": "DEPT 203052",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975977",
            "telephone_number": "630-754-8788",
            "fax_number": "630-754-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 N. CICERO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411807",
            "telephone_number": "773-557-7766",
            "fax_number": "773-557-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "SIMONE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-011451",
            "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 Jun 20, 2012; 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.