Individual provider Active NPI

Philip Anthony Que, D.C.

  • Chiropractor
  • Carpentersville, IL
National Provider Identifier
1073649752
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011044 Issued in IL
Practice address
2259 Randall Rd
Carpentersville, IL 60110-3355
Phone
(847) 551-4410
Fax
(847) 551-4412
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 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 2301009292 MI
Chiropractor 111N00000X 038.011044 IL Primary

Addresses

Primary practice location

2259 Randall Rd
Carpentersville, IL 60110-3355

Mailing address

2259 Randall Rd
Carpentersville, IL 60110-3355
Phone (847) 551-4410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090323000513 IL Practitioner - Chiropractic 1658438460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2259 Randall Rd
Carpentersville, IL 60110-3355
Phone (847) 551-4410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009292MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Living Chiropractic LLC Chiropractor CurrentSince Jan 19, 2009 Accepting new patients

Locations

2259 Randall Rd
Carpentersville, IL 60110
Phone (847) 551-4410

Organizations & group practices 1

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1073649752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 RANDALL RD",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103355",
            "telephone_number": "847-551-4410",
            "fax_number": "847-551-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 RANDALL RD",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601103355",
            "telephone_number": "847-551-4410",
            "fax_number": "847-551-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUE",
        "first_name": "PHILIP",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009292",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carpentersville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.