Individual provider Active NPI

Scott Lyman, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1104644277
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.014187 Issued in IL
Practice address
4555 N Lincoln Ave
Chicago, IL 60625-2102
Phone
(773) 328-8153
NPI assigned
Sep 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.014187 IL Primary

Addresses

Primary practice location

4555 N Lincoln Ave
Chicago, IL 60625-2102

Mailing address

3847 Bergstrom St
Joliet, IL 60431-8705
Phone (815) 666-7873

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203003328 IL Practitioner - Chiropractic 3072049865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Wellness LLCGroup PAC ID 3072752864, 21 clinicians

Practice addresses (Care Compare)

4555 N Lincoln Ave
Chicago, IL 60625-2102
Phone (847) 791-7012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Wellness LLC Chiropractor CurrentSince Sep 24, 2024 Accepting new patients
Active Wellness, LLC Chiropractor CurrentSince Sep 24, 2024 Accepting new patients

Locations

2514 N Milwaukee Ave
Chicago, IL 60647
Phone (312) 216-2452

1335 S Michigan Ave
Chicago, IL 60605
Phone (312) 216-2420

4555 N Lincoln Ave
Chicago, IL 60625
Phone (773) 328-8153

560 W Diversey Pkwy
Chicago, IL 60614
Phone (773) 328-8153

3514 N Southport Ave
Chicago, IL 60657
Phone (773) 248-2544

215 W Superior St
Chicago, IL 60654
Phone (773) 906-5600

710 Deerfield Rd
Deerfield, IL 60015
Phone (224) 632-1860

134 N York St
Elmhurst, IL 60126
Phone (331) 462-1167

910 Davis St
Evanston, IL 60201
Phone (773) 598-4387

20505 N Rand Rd
Ste 218
Kildeer, IL 60047
Phone (847) 481-8728

1105 N Elmhurst Rd
Mt Prospect, IL 60056
Phone (224) 676-2318

15222 S La Grange Rd
Unit 8
Orland Park, IL 60462
Phone (708) 876-8207

15222 S La Grange Rd
Orland Park, IL 60462

40 N Northwest Hwy
Park Ridge, IL 60068
Phone (773) 231-7081

925 N Milwaukee Ave
Unit 300
Vernon Hills, IL 60061
Phone (224) 632-1859

Organizations & group practices 2

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": "1727481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1104644277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3847 BERGSTROM ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318705",
            "telephone_number": "815-666-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252102",
            "telephone_number": "773-328-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.014187",
            "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 Sep 28, 2024; 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.