Individual provider Active NPI

Nunzio J Ambrosino, D.C.

  • Orthopedic Chiropractor
  • Chicago, IL
National Provider Identifier
1194762112
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
038004365 Issued in IL
Practice address
150 E Huron St
Suite 805
Chicago, IL 60611-2999
Phone
(312) 649-6565
Fax
(312) 649-9842
NPI assigned
May 31, 2006
Last updated
Sep 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X 038004365 IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 805
Chicago, IL 60611-2999

Mailing address

1634 S Surrey Ridge Dr
Arlington Heights, IL 60005-3707
Phone (847) 427-9526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000248 IL Practitioner - ChiropracticPractitioner - Hospice/Palliative CarePractitioner - Sports MedicinePractitioner - Physical Medicine and RehabilitationPractitioner - Pain ManagementPractitioner - Preventive Medicine 4082645783 Practice locations: Arlington Heights, IL

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Hospice/Palliative Care, Pain Management, Physical Medicine and Rehabilitation, Preventive Medicine
Education
National College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1634 S Surrey Ridge Dr
Arlington Heights, IL 60005-3707
Phone (630) 202-1656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Shore Adult & Geriatric Medicine, LTD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDJACA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1194762112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 S SURREY RIDGE DR",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053707",
            "telephone_number": "847-427-9526",
            "fax_number": "847-427-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 805",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-649-6565",
            "fax_number": "312-649-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSINO",
        "first_name": "NUNZIO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IL",
            "license": "038004365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.