Organization Active NPI

Elgin Medical Pain Management

  • Chiropractor
  • Schaumburg, IL
National Provider Identifier
1265824734
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ELGIN MEDICAL PAIN MANAGEMENT
Practice address
1037 E Woodfield Rd.
Schaumburg, IL 60173
Phone
(815) 404-3064
Fax
(847) 697-3475
NPI assigned
Feb 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Authorized official

Name
Dr. Michael James Hartlett, D.C.
Title
Ceo
Phone
(815) 404-3064

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X IL
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X IL

Addresses

Primary practice location

1037 E Woodfield Rd.
Schaumburg, IL 60173

Mailing address

1116 Palmer CT
Crystal Lake, IL 60014-6938
Phone (815) 404-3064

Other identifiers 1

IdentifierTypeStateIssuer
1500023738OtherILCITY OF ELGIN LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1265824734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 PALMER CT",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146938",
            "telephone_number": "815-404-3064",
            "fax_number": "847-697-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 E WOODFIELD RD.",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60173",
            "telephone_number": "815-404-3064",
            "fax_number": "847-697-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN MEDICAL PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "HARTLETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-404-3064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY OF ELGIN LICENSE",
            "identifier": "1500023738",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.