Individual provider Active NPI

Thomas Macneill-Zimmerman, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1255423372
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-007981 Issued in IL
Practice address
1644 E 53Rd St
Suite a
Chicago, IL 60615-4210
Phone
(773) 322-1123
Fax
(773) 322-1126
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-007981 IL Primary

Addresses

Primary practice location

1644 E 53Rd St
Suite a
Chicago, IL 60615-4210

Mailing address

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523-1234
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131107001716 IL Practitioner - Chiropractic 9638304132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1644 E 53Rd St
A
Chicago, IL 60615-4489
Phone (773) 819-9004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007981ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro Wellness Center Metro of Hyde Park LLC Chiropractor CurrentSince Sep 4, 2014 Accepting new patients
Chiro One Wellness Center Metro of Lakeview LLC Chiropractor PastSince May 5, 2017 Accepting new patients

Locations

1644 E 53rd St
#A
Chicago, IL 60615
Phone (773) 322-1123

1644 E 53rd St
Ste A
Chicago, IL 60615
Phone (773) 322-1123

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

Organizations & group practices 2

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1255423372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD",
            "address_2": "STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231234",
            "telephone_number": "630-468-1824",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 E 53RD ST",
            "address_2": "SUITE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154210",
            "telephone_number": "773-322-1123",
            "fax_number": "773-322-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNEILL-ZIMMERMAN",
        "first_name": "THOMAS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-007981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.