Organization Active NPI

Breton Chiropractic, LTD

  • Internist Chiropractor
  • Arlington Heights, IL
National Provider Identifier
1073793345
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
038008779 Issued in IL
Legal business name
BRETON CHIROPRACTIC, LTD
Practice address
815 E Rand Rd
Arlington Heights, IL 60004-4007
Phone
(847) 368-1234
Fax
(847) 603-7478
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Authorized official

Name
Dr. Shawn M Breton, DC DABCINPI 1740273119
Title
President, Ceo
Phone
(847) 368-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internist ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NI0900X 038008779 IL Primary
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X 038.009584 IL

Addresses

Primary practice location

815 E Rand Rd
Arlington Heights, IL 60004-4007

Mailing address

815 E Rand Rd
Arlington Heights, IL 60004-4007
Phone (847) 368-1234

Other identifiers 2

IdentifierTypeStateIssuer
211798OtherILMEDICARE GROUP NUMBER
0001635079OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000497 IL Part B Supplier - Clinic/Group Practice 4385688456 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington Heights, IL

National Provider Directory

National Provider Directory

Locations

815 E Rand Rd
Arlington Hts, IL 60004
Phone (312) 253-2112

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722643200000",
    "number": "1073793345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E RAND RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044007",
            "telephone_number": "847-368-1234",
            "fax_number": "847-603-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E RAND RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044007",
            "telephone_number": "847-368-1234",
            "fax_number": "847-603-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETON CHIROPRACTIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A",
        "authorized_official_last_name": "BRETON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "847-368-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC DABCI"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": "038008779",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038.009584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "211798",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001635079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.