Individual provider Active NPI

Dimitry Likterev, DC

  • Neurology Chiropractor
  • Arlington Heights, IL
National Provider Identifier
1124193966
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
038-010245 Issued in IL
Practice address
1655 N Arlington Heights Rd Ste 101W
Arlington Heights, IL 60004-3976
Phone
(847) 870-8955
Fax
(847) 770-4458
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 038-010245 IL Primary

Addresses

Primary practice location

1655 N Arlington Heights Rd Ste 101W
Arlington Heights, IL 60004-3976

Mailing address

PO Box 4901
Buffalo Grove, IL 60089-4901
Phone (847) 870-8955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000872 IL Practitioner - Chiropractic 3577527696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Absolute Medical and Diagnostic Center, SCGroup PAC ID 6709936859, 5 clinicians
Absolute Wellness and Rehab, Inc.Group PAC ID 9335226224, 2 clinicians

Practice addresses (Care Compare)

1655 N Arlington Heights Rd
Suite 101W
Arlington Heights, IL 60004-3976
Phone (847) 870-8955

720 S Rand Rd
Lake Zurich, IL 60047-2467
Phone (847) 438-0055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010245ILMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Wellness & Rehab, Inc. CurrentSince Sep 1, 2024 Accepting new patients
A Bridge Back, Inc. Current Accepting new patients
Absolute Medical & Diagnostic Center, SC Neurology CurrentSince Oct 1, 2004 Accepting new patients
My Absolute Body Inc Neurology CurrentSince Jul 1, 2020 Accepting new patients
A Bridge Back, Inc. Current Accepting new patients
RR Medical Management Past Accepting new patients
Y.S. Cherny & Associates M.D, LTD. Past Accepting new patients
Midwest Examination Services, Inc Neurology PastSince Mar 20, 2001 Accepting new patients

Locations

1655 N Arlington Heights Rd
Ste 101W
Arlington Heights, IL 60004
Phone (847) 305-3610

720 S Rand Rd
Lake Zurich, IL 60047
Phone (847) 438-0055

2640 Sheridan Rd
Zion, IL 60099
Phone (847) 731-6727

Organizations & group practices 8

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1124193966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4901",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894901",
            "telephone_number": "847-870-8955",
            "fax_number": "847-770-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 N ARLINGTON HEIGHTS RD STE 101W",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043976",
            "telephone_number": "847-870-8955",
            "fax_number": "847-770-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIKTEREV",
        "first_name": "DIMITRY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IL",
            "license": "038-010245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.