Kevin A Fredericks, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

166 N Gary Ave
Carol Stream, IL 60188-2093

Phone

(630) 665-5656

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fredericks Chiropractic Center, LTD.

  • Chiropractor
  • Carol Stream, IL
  • NPI 1063673572
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104906213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882093",
            "telephone_number": "630-665-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 N GARY AVE",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882093",
            "telephone_number": "630-665-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "KEVIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Cleo Fowler, D.C.
• Francis S Lichon MD SC
• Patricia Rose Francis, PSY.D.
• Adriana Patricia Franco, LCSW, CRADC
• Fredericks Chiropractic Center, LTD.
• David A Fruhauf, D.C.
• Jordyn Fulton, OTD, OTR/L
• Parth Gabhawala, PT
• Katarzyna Gacek, FNP-BC
• Darshan Gandhi

• Chiropractor in Carol Stream, IL
• Providers in Carol Stream, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.