Individual provider Active NPI

Hovig Vartanian, DC

  • Chiropractor
  • Niles, IL
National Provider Identifier
1215016134
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
241 Golf Mill Center
Suite 600
Niles, IL 60714
Phone
(847) 699-8888
Fax
(847) 699-8830
NPI assigned
Nov 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

241 Golf Mill Center
Suite 600
Niles, IL 60714

Mailing address

241 Golf Mill Center
Suite 600
Niles, IL 60714
Phone (847) 699-8888

Other identifiers 2

IdentifierTypeStateIssuer
01623055OtherILBCBS OF IL
P00237274OtherILRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000449 IL Practitioner - Chiropractic 5193700649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Wellness, LLC Chiropractor CurrentSince Jun 23, 2024 Accepting new patients
Active Wellness LLC Chiropractor CurrentSince Jun 23, 2024 Accepting new patients
North Shore Physical Medicine Chiropractor PastSince Jun 1, 2008 Accepting new patients

Locations

4555 N Lincoln Ave
Chicago, IL 60625
Phone (773) 328-8153

710 Deerfield Rd
Deerfield, IL 60015
Phone (224) 632-1860

40 N Northwest Hwy
Park Ridge, IL 60068
Phone (773) 231-7081

Organizations & group practices 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215016134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 GOLF MILL CENTER",
            "address_2": "SUITE 600",
            "city": "NILES",
            "state": "IL",
            "postal_code": "60714",
            "telephone_number": "847-699-8888",
            "fax_number": "847-699-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 GOLF MILL CENTER",
            "address_2": "SUITE 600",
            "city": "NILES",
            "state": "IL",
            "postal_code": "60714",
            "telephone_number": "847-699-8888",
            "fax_number": "847-699-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTANIAN",
        "first_name": "HOVIG",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01623055",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00237274",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.