Justin M Coop, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010123 Issued in IL

Practice address

24W788 75TH St
Naperville, IL 60565

Phone

(630) 465-6685

Fax

(630) 445-0544

NPI assigned

Dec 15, 2006

Last updated

Nov 20, 2018By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1114089109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24W788 75TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651684",
            "telephone_number": "630-465-6685",
            "fax_number": "630-445-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24W788 75TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60565",
            "telephone_number": "630-465-6685",
            "fax_number": "630-445-0544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 Mediterranean Dr",
            "address_2": "Unit 101",
            "address_purpose": "LOCATION",
            "city": "Sycamore",
            "state": "IL",
            "postal_code": "601783142",
            "country_code": "US",
            "telephone_number": "815-899-6061",
            "fax_number": "815-899-7573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOP",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "K12763",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1841493111",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conventions RX, LTD
• Sophia Cook, RDN
• Steven Cook
• Christine Sevcik Cooke, PT
• Danielle M Cooling, M.D.
• Ellaine Cooper-Taillandier, LSW
• Jessica K Cooperkline, BCBA
• Copyright, Inc. of Illinois
• Rachel Cordova
• Samuel Mauricio Cordova, PA-C

• Chiropractor in Naperville, IL
• Providers in Naperville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.