Active NPI
Steven Robert Segal, D.C.
- Sports Physician Chiropractor
- Libertyville, IL
National Provider Identifier
1053491746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 038-006415
- Practice address
- 503 E Park Ave
Ste 1N
Libertyville, IL 60048-2886 - Phone
- (847) 778-3627
- NPI assigned
- Oct 17, 2006
- Last updated
- Jan 17, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 038-006415 | IL | Primary |
Addresses
Primary practice location
503 E Park Ave
Ste 1N
Libertyville, IL 60048-2886
Mailing address
503 E Park Ave
Ste 1N
Libertyville, IL 60048-2886
Phone (847) 778-3627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071029000580 | IL | Practitioner - Chiropractic | 5890882476 | Practice locations: Libertyville, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- National College of Chiropractic, 1989
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
503 E Park Ave
Libertyville, IL 60048-2886
Phone (847) 778-3627
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-006415 | IL | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1053491746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 E PARK AVE",
"address_2": "STE 1N",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600482886",
"telephone_number": "847-778-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 E PARK AVE",
"address_2": "STE 1N",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600482886",
"telephone_number": "847-778-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEGAL",
"first_name": "STEVEN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "IL",
"license": "038-006415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.