Individual provider Active NPI

Andrena Sayles, D.C.

  • Chiropractor
  • Pecatonica, IL
National Provider Identifier
1114053840
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009552 Issued in IL
Practice address
427 N Main St
Pecatonica, IL 61063
Phone
(815) 239-1121
Fax
(815) 239-2766
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009552 IL Primary

Addresses

Primary practice location

427 N Main St
Pecatonica, IL 61063

Mailing address

650 Merrion Rd
Roscoe, IL 61073-6302
Phone (815) 623-5975

Other identifiers 1

IdentifierTypeStateIssuer
038-009552OtherILLICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000615 IL Practitioner - Chiropractic 9436274982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 W Main St
Rockton, IL 61072-2419
Phone (815) 957-0737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009552ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Changes Chiropractic, LTD CurrentSince May 10, 2010 Accepting new patients
Pecatonica Chiropractic Center Chiropractor PastSince Dec 1, 2014 Accepting new patients

Locations

202 W Main St
Rockton, IL 61072
Phone (815) 957-0737

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114053840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MERRION RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610736302",
            "telephone_number": "815-623-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N MAIN ST",
            "city": "PECATONICA",
            "state": "IL",
            "postal_code": "61063",
            "telephone_number": "815-239-1121",
            "fax_number": "815-239-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYLES",
        "first_name": "ANDRENA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "038-009552",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pecatonica, IL

Sources for this page

  • 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.