Individual provider Active NPI

Robert Todd Baj, DC

  • Chiropractor
  • Winnetka, IL
National Provider Identifier
1104975184
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008968 Issued in IL
Practice address
46 Green Bay Rd
Winnetka, IL 60093-4006
Phone
(847) 920-0186
Fax
(847) 920-0189
NPI assigned
Jan 9, 2007
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008968 IL Primary

Addresses

Primary practice location

46 Green Bay Rd
Winnetka, IL 60093-4006

Mailing address

46 Green Bay Rd
Winnetka, IL 60093-4006
Phone (847) 920-0186

Other identifiers 1

IdentifierTypeStateIssuer
01625589OtherILBLUECROSSBLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000873 IL Practitioner - Chiropractic 9234035650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

562 Green Bay Rd
Kenilworth, IL 60043-1053
Phone (847) 920-0186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008968ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Interactive Health Associates Inc Chiropractor CurrentSince Jan 2, 2000 Accepting new patients
Chicago Chiropractic & Sports Medicine LLC Chiropractor PastSince Jan 2, 2000 Accepting new patients

Locations

562 Green Bay Rd
Kenilworth, IL 60043
Phone (847) 881-2861

46 Green Bay Rd
Winnetka, IL 60093
Phone (630) 418-1905

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1104975184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 GREEN BAY RD",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934006",
            "telephone_number": "847-920-0186",
            "fax_number": "847-920-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 GREEN BAY RD",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934006",
            "telephone_number": "847-920-0186",
            "fax_number": "847-920-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJ",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "01625589",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnetka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.