Preferred Chiropractic Care Center P C

Primary specialty

Internist ChiropractorTaxonomy code 111NI0900X

License

038-007306 Issued in IL

Legal business name

PREFERRED CHIROPRACTIC CARE CENTER P C

Practice address

109 1St St
Bloomingdale, IL 60108-1219

Phone

(630) 539-5822

Fax

(630) 539-5824

NPI assigned

Jan 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alex Zevan III, DC, FIACA, DABCI

Title

President

Phone

(630) 539-5822

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1215083530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6548",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601086548",
            "telephone_number": "630-539-5822",
            "fax_number": "630-539-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 1ST ST",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081219",
            "telephone_number": "630-539-5822",
            "fax_number": "630-539-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED CHIROPRACTIC CARE CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-27",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ZEVAN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-539-5822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC, FIACA, DABCI"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Internist",
            "state": "IL",
            "license": "038-007306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "222-0421",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1225120876",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internist Chiropractor in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Internist Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.