Individual provider Active NPI

Sean Stewart, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1104257781
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012529 Issued in IL
Practice address
3132 N Sheffield Ave
Chicago, IL 60657-9024
Phone
(773) 938-0566
Fax
(312) 376-4033
NPI assigned
Dec 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012529 IL Primary

Addresses

Primary practice location

3132 N Sheffield Ave
Chicago, IL 60657-9024

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 320-6400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140130001458 IL Practitioner - Chiropractic 2163651761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3132 N Sheffield Ave
Chicago, IL 60657-9024
Phone (773) 572-0090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012529ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center Metro of Lakeview LLC Chiropractor CurrentSince May 5, 2021 Accepting new patients

Locations

3132 N Sheffield Ave
Chicago, IL 60657
Phone (773) 572-0090

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

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": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1104257781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-320-6400",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 N SHEFFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579024",
            "telephone_number": "773-938-0566",
            "fax_number": "312-376-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SEAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-06",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.