Individual provider Active NPI

Christian Yoon Song, D.C.

  • Chiropractor
  • Hoffman Estates, IL
National Provider Identifier
1215138094
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
8 Golf Ctr
Hoffman Estates, IL 60169-4910
Phone
(847) 755-0400
Fax
(847) 755-0414
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

8 Golf Ctr
Hoffman Estates, IL 60169-4910

Mailing address

8 Golf Ctr
Hoffman Estates, IL 60169-4910
Phone (847) 755-0400

Other identifiers 1

IdentifierTypeStateIssuer
01623415OtherILBC BS PPO

Other names 1

  • Dr. Yoon Soo Song Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080409000220 IL Practitioner - Chiropractic 5092892430 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

8 Golf Ctr
Hoffman Estates, IL 60169-4910
Phone (847) 755-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008386ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Regional Physician Services, LLC Past Accepting new patients
Faith Regional Physician Services, LLC PastSince Dec 28, 2015 Accepting new patients
Park Wellness Chiropractic & Acupuncture PC Chiropractor PastSince Feb 23, 1999 Accepting new patients

Organizations & group practices 4

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1215138094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GOLF CTR",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601694910",
            "telephone_number": "847-755-0400",
            "fax_number": "847-755-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GOLF CTR",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601694910",
            "telephone_number": "847-755-0400",
            "fax_number": "847-755-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "CHRISTIAN",
        "middle_name": "YOON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PPO",
            "identifier": "01623415",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YOON",
            "last_name": "SONG",
            "middle_name": "SOO",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.