Active NPI
Maurice Velasco, DC
- Chiropractor
- Bensenville, IL
National Provider Identifier
1245333632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038007228
- Practice address
- 165 N Church Rd
Bensenville, IL 60106 - Phone
- (630) 238-9345
- Fax
- (630) 238-9344
- NPI assigned
- Sep 7, 2006
- Last updated
- Sep 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038007228 | IL | Primary |
Addresses
Primary practice location
165 N Church Rd
Bensenville, IL 60106
Mailing address
PO Box 177
Bensenville, IL 60106-0177
Phone (630) 238-9345
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02219455 | Other | IL | BLUE CROSS BLUE SHIELD |
| 038007228 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038007228 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back in Action Holistic Health Center | Chiropractor | Past | Accepting new patients |
| Northern Illinois Medical Group S. C. | Chiropractor | Past | Accepting new patients |
| Family Chiropractic Clinic of Bensenville | Chiropractor | Past | Accepting new patients |
Interoperability endpoints
- maurico.velasco.1@20980.direct.athenahealth.com
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.
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Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221609600000",
"number": "1245333632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 177",
"city": "BENSENVILLE",
"state": "IL",
"postal_code": "601060177",
"telephone_number": "630-238-9345",
"fax_number": "630-238-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 N CHURCH RD",
"city": "BENSENVILLE",
"state": "IL",
"postal_code": "60106",
"telephone_number": "630-238-9345",
"fax_number": "630-238-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELASCO",
"first_name": "MAURICE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2008-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038007228",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "02219455",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038007228",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bensenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.