Active NPI
Keith A Kretschmar, D.C.
- Chiropractor
- Fox River Grove, IL
National Provider Identifier
1073549556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038005142
- Practice address
- 912 Northwest Hwy
Suite 104
Fox River Grove, IL 60021-1925 - Phone
- (815) 451-8331
- NPI assigned
- Jun 25, 2006
- Last updated
- May 11, 2009
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038005142 | IL | Primary |
Addresses
Primary practice location
912 Northwest Hwy
Suite 104
Fox River Grove, IL 60021-1925
Mailing address
338 Carl Sands Dr
Cary, IL 60013-3112
Phone (815) 451-8331
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
| License | State | Type | Specialty |
|---|---|---|---|
| 038005142 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242000000000",
"number": "1073549556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 CARL SANDS DR",
"city": "CARY",
"state": "IL",
"postal_code": "600133112",
"telephone_number": "815-451-8331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 NORTHWEST HWY",
"address_2": "SUITE 104",
"city": "FOX RIVER GROVE",
"state": "IL",
"postal_code": "600211925",
"telephone_number": "815-451-8331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRETSCHMAR",
"first_name": "KEITH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2009-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038005142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fox River Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.