Individual provider Active NPI

Christopher Kudyba, D.C.

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1235571084
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012393 Issued in IL
Practice address
4015 Plainfield Naperville Rd
Suite 105
Naperville, IL 60564-4238
Phone
(630) 904-9700
Fax
(630) 904-9713
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012393 IL Primary

Addresses

Primary practice location

4015 Plainfield Naperville Rd
Suite 105
Naperville, IL 60564-4238

Mailing address

4015 Plainfield Naperville Rd
Suite 105
Naperville, IL 60564-4238
Phone (630) 904-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022001539 IL Practitioner - Chiropractic 8325273634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1805 N Mill St
Suite E
Naperville, IL 60563-4860
Phone (630) 791-0058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012393ILMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1235571084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 PLAINFIELD NAPERVILLE RD",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644238",
            "telephone_number": "630-904-9700",
            "fax_number": "630-904-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 PLAINFIELD NAPERVILLE RD",
            "address_2": "SUITE 105",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644238",
            "telephone_number": "630-904-9700",
            "fax_number": "630-904-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDYBA",
        "first_name": "CHRISTOPHER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.