Joel Keith Fish, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006511 Issued in IL

Practice address

34930 N US Highway 45
Suite 109
Lake Villa, IL 60046-7537

Phone

(847) 662-1920

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lake Zurich Physical Medicine, SC

  • Chiropractor
  • Lake Zurich, IL
  • NPI 1376616789
  NPD (past)
• North Suburban Medical S.C.

  • Physical Medicine & Rehabilitation Physician
  • Gurnee, IL
  • NPI 1992853105
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1285748939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34930 N US HIGHWAY 45",
            "address_2": "SUITE 109",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600467537",
            "telephone_number": "847-662-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34930 N US HIGHWAY 45",
            "address_2": "SUITE 109",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600467537",
            "telephone_number": "847-662-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "JOEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Michelle Edmiston, M.D.
• Embrace Behavioral Health
• Elizabeth Ericksen, LPC
• Eugene Pomeranets M.D.S.C.,
• Family Care of Lake County S.C.
• Shontae L Fisher
• Thomas Joseph Forman
• Laura Franz
• G. Neil Garrett DDS PC
• Chelsea Gahgan, SLP

• Chiropractor in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.