Individual provider Active NPI

Tamara St. John, D.C.

  • Chiropractor
  • Carpentersville, IL
National Provider Identifier
1114030228
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007451 Issued in IL
Practice address
160 N Western Ave
Carpentersville, IL 60110-1732
Phone
(630) 935-2791
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038007451 IL Primary

Addresses

Primary practice location

160 N Western Ave
Carpentersville, IL 60110-1732

Mailing address

160 N Western Ave
Carpentersville, IL 60110-1732
Phone (630) 935-2791

Other practice location 1

202 S Marion St
Oak Park, IL 60302-3104
Phone (630) 935-2791

Other identifiers 2

IdentifierTypeStateIssuer
2207639OtherILBCBSI
P149948OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060303000494 IL Practitioner - Chiropractic 8123034857 Reassigns benefits to 1 organization
Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

160 N Western Ave
Carpentersville, IL 60110-1732
Phone (847) 426-2420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038007451ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nikanth Inc Chiropractor CurrentSince Aug 20, 2014 Accepting new patients
DM Cameron DC PC Chiropractor PastSince Jan 1, 2006 Accepting new patients
Davis Chiropractic, LTD Chiropractor PastSince Nov 1, 1999 Accepting new patients
Freeberg Chiropractic Center S.C. Chiropractor Past Accepting new patients

Locations

212 Lincoln Ave
West Dundee, IL 60118
Phone (847) 426-2420

Organizations & group practices 4

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1114030228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N WESTERN AVE",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601101732",
            "telephone_number": "630-935-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N WESTERN AVE",
            "city": "CARPENTERSVILLE",
            "state": "IL",
            "postal_code": "601101732",
            "telephone_number": "630-935-2791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 S Marion St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603023104",
            "country_code": "US",
            "telephone_number": "630-935-2791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "TAMARA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSI",
            "identifier": "2207639",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P149948",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carpentersville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.