Individual provider Active NPI

Alexander Charles Grothman, D.C.

  • Chiropractor
  • Aurora, IL
National Provider Identifier
1245638386
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012725 Issued in IL
Practice address
845 N Lake St Ste 1
Aurora, IL 60506-3178
Phone
(630) 844-1244
Fax
(630) 844-1199
NPI assigned
Dec 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012725 IL Primary

Addresses

Primary practice location

845 N Lake St Ste 1
Aurora, IL 60506-3178

Mailing address

845 N. Lake St., Ste 1
Aurora, IL 60506-3150
Phone (630) 844-1244

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038.012725ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1245638386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N. LAKE ST., STE 1",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063150",
            "telephone_number": "630-844-1244",
            "fax_number": "630-844-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N LAKE ST STE 1",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063178",
            "telephone_number": "630-844-1244",
            "fax_number": "630-844-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHMAN",
        "first_name": "ALEXANDER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.