Individual provider Active NPI

George R Brown, DC CCN

  • Chiropractor
  • Evanston, IL
National Provider Identifier
1134286644
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038005006 Issued in IL
Practice address
500 Davis St
Suite 815
Evanston, IL 60201-4668
Phone
(847) 425-9120
Fax
(847) 425-9125
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 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 038005006 IL Primary

Addresses

Primary practice location

500 Davis St
Suite 815
Evanston, IL 60201-4668

Mailing address

500 Davis St
Suite 815
Evanston, IL 60201-4668
Phone (847) 425-9120

Other names 1

  • Rick Brown Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000367 IL Practitioner - Chiropractic 3678666591 Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Custer Ave
Suite 6
Evanston, IL 60202-2273
Phone (847) 425-9120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038005006ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1134286644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DAVIS ST",
            "address_2": "SUITE 815",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014668",
            "telephone_number": "847-425-9120",
            "fax_number": "847-425-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DAVIS ST",
            "address_2": "SUITE 815",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014668",
            "telephone_number": "847-425-9120",
            "fax_number": "847-425-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GEORGE",
        "middle_name": "R",
        "credential": "DC CCN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICK",
            "last_name": "BROWN",
            "credential": "DC CCN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.