Individual provider Active NPI

Jose Luis Aguilar Jr., D.C.

  • Chiropractor
  • Northbrook, IL
National Provider Identifier
1073556486
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.010421 Issued in IL
Practice address
300 Skokie Blvd
Stel
Northbrook, IL 60062-1625
Phone
(773) 218-0097
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010421 IL
Chiropractor 111N00000X 038.010421 IL Primary

Addresses

Primary practice location

300 Skokie Blvd
Stel
Northbrook, IL 60062-1625

Mailing address

300 Skokie Blvd
Ste L
Northbrook, IL 60062-1625
Phone (773) 218-0097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000101 IL Practitioner - Chiropractic 0749215614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.010421ILMDChiropractor
038010421ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Illinois Medical PC CurrentSince Apr 3, 2025 Accepting new patients
Premise Health of Illinois Medical PC Current Accepting new patients
Diversey Medical Center SC Chiropractor PastSince Aug 11, 2010 Accepting new patients
Chiromend Chiropractor Past Accepting new patients

Locations

16906 Collection Ctr Dr
Chicago, IL 60693

6150 Joliet Rd
Countryside, IL 60525
Phone (708) 485-2273

4179 Dundee Rd
Ste A106
Northbrook, IL 60062
Phone (847) 402-2300

5500 Maryland Way
Ste 120
Brentwood, TN 37027

Organizations & group practices 4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1073556486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SKOKIE BLVD",
            "address_2": "STE L",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621625",
            "telephone_number": "773-218-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SKOKIE BLVD",
            "address_2": "STEL",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621625",
            "telephone_number": "773-218-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010421",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.010421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.