Organization Active NPI

Ultimate Chiro Care PC

  • Chiropractor
  • Woodridge, IL
National Provider Identifier
1093994154
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006843 Issued in IL
Legal business name
ULTIMATE CHIRO CARE PC
Practice address
3590 Hobson Rd Ste 301
Woodridge, IL 60517-5409
Phone
(630) 778-9000
Fax
(630) 778-9065
NPI assigned
Oct 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Authorized official

Name
Dr. Perry Anthony Cammisa, DCNPI 1497853071
Title
Owner/Sole Proprietor
Phone
(630) 778-9000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038006843 IL Primary

Addresses

Primary practice location

3590 Hobson Rd Ste 301
Woodridge, IL 60517-5409

Mailing address

3590 Hobson Rd
Woodridge, IL 60517-5409
Phone (630) 778-9000

Other identifiers 2

IdentifierTypeStateIssuer
00290120OtherILBLUE CROSS BLUE SHIELD IL
00290120OtherILBLUECROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000217 IL Part B Supplier - Clinic/Group Practice 0547359507 Receives reassigned benefits from 2 practitioners
Practice locations: Woodridge, IL

National Provider Directory

National Provider Directory

Locations

3590 Hobson Rd
Woodridge, IL 60517

Interoperability endpoints

  • Direct secure messaging: perryucc@ucp0001.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 4

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": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1093994154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD STE 301",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-778-9000",
            "fax_number": "630-778-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE CHIRO CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "CAMMISA",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "630-778-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "00290120",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "00290120",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.