Kevin Patrick Reider, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013988 Issued in IL

Practice address

6178 N Northwest Hwy
Chicago, IL 60631-2126

Phone

(773) 570-6404

NPI assigned

May 8, 2023

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

Palmer College Chiropractic - Davenport, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Deep Roots Chiropractic & Wellness Center LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1750071874
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1114616802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6178 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312126",
            "telephone_number": "773-570-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6178 N NORTHWEST HWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312126",
            "telephone_number": "773-570-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDER",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santashia Reid
• Spencer Douglas Reid
• Virgil Cayton Reid III, MD
• Bruce Reider
• Jaclyn Reider, CPNP-AC
• Clare Kelly Reidy, DO
• Jean Elizabeth Reidy, APN
• Kate Maureen Reidy, DO
• Alana Reifer, DDS
• Stefanie N Reiff, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.