Individual provider Active NPI

Michael James Hartlett, D.C.

  • Chiropractor
  • Elgin, IL
National Provider Identifier
1063658656
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011277 Issued in IL
Practice address
810 S McLean Blvd
Elgin, IL 60123-6703
Phone
(847) 697-3472
Fax
(847) 697-3475
NPI assigned
Jan 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011277 IL Primary

Addresses

Primary practice location

810 S McLean Blvd
Elgin, IL 60123-6703

Mailing address

3 W Hawthorn Pkwy Ste 280
Vernon Hills, IL 60061-1446
Phone (224) 424-3147

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090528000544 IL Practitioner - Chiropractic 6305995044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integral Medical and Rehabilitation SCGroup PAC ID 1850641820, 2 clinicians

Practice addresses (Care Compare)

3 W Hawthorn Pkwy
Suite 280
Vernon Hills, IL 60061-1446
Phone (224) 424-3147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011277ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Medical & Rehabilitation, S.C Chiropractor CurrentSince May 1, 2018 Accepting new patients
McHenry Medical Center SC Chiropractor Past Accepting new patients
Superiorhealth & Wellness of McHenry LTD Chiropractor Past Accepting new patients

Locations

870 W End Ct
Ste 206
Vernon Hills, IL 60061
Phone (224) 424-3147

3 W Hawthorn Pkwy
Ste 280
Vernon Hills, IL 60061
Phone (224) 424-3147

Organizations & group practices 3

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": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1063658656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 W HAWTHORN PKWY STE 280",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611446",
            "telephone_number": "224-424-3147",
            "fax_number": "224-304-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MCLEAN BLVD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236703",
            "telephone_number": "847-697-3472",
            "fax_number": "847-697-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLETT",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.

Verify at the official NPI Registry.