Individual provider Active NPI

Louis Santino Deberardinis, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1265325179
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038014255 Issued in IL
Practice address
1147 S Wabash Ave Ste 250B
Chicago, IL 60605-2355
Phone
(312) 987-4878
NPI assigned
May 30, 2025
Last updated
May 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038014255 IL Primary

Addresses

Primary practice location

1147 S Wabash Ave Ste 250B
Chicago, IL 60605-2355

Mailing address

18341 Oak Park Ave
Tinley Park, IL 60477-4136

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250627001261 IL Practitioner - Chiropractic 1052824679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038014255ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Health Medical LTD CurrentSince Jun 2, 2025 Accepting new patients
Kowalik Chiropractic Inc Chiropractor Current Accepting new patients

Locations

1147 S Wabash Ave
Chicago, IL 60605
Phone (312) 360-1604

1147 S Wabash Ave
Ste 250B
Chicago, IL 60605
Phone (312) 987-4878

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1265325179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18341 OAK PARK AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 S WABASH AVE STE 250B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052355",
            "telephone_number": "312-987-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERARDINIS",
        "first_name": "LOUIS",
        "middle_name": "SANTINO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038014255",
            "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 May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.