Individual provider Active NPI

Christopher J Halliday

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1063432532
Registry record updated Mar 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009504 Issued in IL
Practice address
3505 N. Ashland Ave.
Chicago, IL 60657
Phone
(773) 248-4229
Fax
(773) 248-4222
NPI assigned
Jul 20, 2006
Last updated
Mar 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009504 IL Primary

Addresses

Primary practice location

3505 N. Ashland Ave.
Chicago, IL 60657

Mailing address

1225 W Morse Ave
#401
Chicago, IL 60626-5798
Phone (773) 931-8310

Other identifiers 2

IdentifierTypeStateIssuer
35-2311941OtherILFEIN
7859515OtherILAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061011000735 IL Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 8628074853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
National College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3505 N Ashland Ave
Chicago, IL 60657-1313
Phone (773) 248-4229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009504ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Chicago Body Works, S.C. Chiropractor CurrentSince Mar 7, 2008 Accepting new patients
Gutrich Chiropractic, Inc. Chiropractor Past Accepting new patients

Locations

3505 N Ashland Ave
Chicago, IL 60657
Phone (773) 248-4229

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204329600000",
    "number": "1063432532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MORSE AVE",
            "address_2": "#401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606265798",
            "telephone_number": "773-931-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 N. ASHLAND AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-248-4229",
            "fax_number": "773-248-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "35-2311941",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7859515",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.