Individual provider Active NPI

Alexander Ayzenshteyn, D.C.

  • Chiropractor
  • Northbrook, IL
National Provider Identifier
1285936328
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011825 Issued in IL
Practice address
3000 Dundee Rd
308
Northbrook, IL 60062-2422
Phone
(847) 254-4970
NPI assigned
Nov 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011825 IL Primary

Addresses

Primary practice location

3000 Dundee Rd
308
Northbrook, IL 60062-2422

Mailing address

791 Dunhill Dr
Buffalo Grove, IL 60089-1514
Phone (847) 254-4970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110803000273 IL Practitioner - Chiropractic 9436328762
I20240306000416 IN Practitioner - Chiropractic 9436328762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Joint Associates of Mishawaka IncGroup PAC ID 2163749524, 3 clinicians

Practice addresses (Care Compare)

229 Red Coach Dr
Suite 106
Mishawaka, IN 46545-3195
Phone (574) 318-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011825ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Joint Associates of Mishawaka, Inc Chiropractor CurrentSince Feb 26, 2024 Accepting new patients
Ayzenshteyn Chiropractic Chiropractor Past Accepting new patients
Ayzenshteyn Chiropractic Chiropractor Past Accepting new patients

Locations

229 Red Coach Dr
Ste 107
Mishawaka, IN 46545
Phone (574) 318-7800

229 Red Coach Dr
Ste 106
Mishawaka, IN 46545
Phone (574) 318-7800

Organizations & group practices 3

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": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1285936328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 DUNHILL DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891514",
            "telephone_number": "847-254-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD",
            "address_2": "308",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622422",
            "telephone_number": "847-254-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYZENSHTEYN",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.