Individual provider Active NPI

Andrew B Serlin, D.C.

  • Chiropractor
  • Northbrook, IL
National Provider Identifier
1124067442
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010489 Issued in IL
Practice address
3113 Dundee Rd
Northbrook, IL 60062-2402
Phone
(224) 723-5693
Fax
(224) 723-5073
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010489 IL Primary

Addresses

Primary practice location

3113 Dundee Rd
Northbrook, IL 60062-2402

Mailing address

3113 Dundee Rd
Northbrook, IL 60062-2402
Phone (224) 723-5693

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060116000300 IL Practitioner - Chiropractic 5496779662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National University of Health SciencesGroup PAC ID 2567351521, 4 clinicians

Practice addresses (Care Compare)

200 E Roosevelt Rd
Lombard, IL 60148-4539
Phone (630) 629-9664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038010489ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
National University of Health Sciences Chiropractor CurrentSince Nov 20, 2019 Accepting new patients

Locations

200 E Roosevelt Rd
Lombard, IL 60148
Phone (630) 629-9664

200 E Roosevelt Rd
Bldg B
Lombard, IL 60148
Phone (630) 889-6453

Interoperability endpoints

  • Direct secure messaging: andrew.serlin.1@11209.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1124067442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622402",
            "telephone_number": "224-723-5693",
            "fax_number": "224-723-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622402",
            "telephone_number": "224-723-5693",
            "fax_number": "224-723-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERLIN",
        "first_name": "ANDREW",
        "middle_name": "B",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.