NPIMap

Organization Active NPI

Advanced Sports Medicine SC

  • Chiropractor
  • Elgin, IL
National Provider Identifier
1083932602
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009968 Issued in IL
Legal business name
ADVANCED SPORTS MEDICINE SC
Practice address
1750 N Randall Rd
Suite 250
Elgin, IL 60123-7900
Phone
(224) 856-2494
Fax
(224) 856-2495
NPI assigned
May 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Authorized official

Name
Dr. Thomas M Mitchell, D.C.
Title
Owner
Phone
(630) 346-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038009968 IL Primary

Addresses

Primary practice location

1750 N Randall Rd
Suite 250
Elgin, IL 60123-7900

Mailing address

1750 N Randall Rd
Suite 250
Elgin, IL 60123-7900
Phone (224) 856-2494

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1083932602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N RANDALL RD",
            "address_2": "SUITE 250",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237900",
            "telephone_number": "224-856-2494",
            "fax_number": "224-856-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N RANDALL RD",
            "address_2": "SUITE 250",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237900",
            "telephone_number": "224-856-2494",
            "fax_number": "224-856-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPORTS MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-06",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-346-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009968",
            "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 Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.