Organization Active NPI

Chicago Chiropractic Group LTD

  • Chiropractor
  • Hampshire, IL
National Provider Identifier
1295002152
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009968 Issued in IL
Legal business name
CHICAGO CHIROPRACTIC GROUP LTD
Practice address
1361 Pheasant TRL
Hampshire, IL 60140-7413
Phone
(630) 346-3600
NPI assigned
Nov 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Dr. Thomas M Mitchell, D.C.NPI 1336194679
Title
Owner
Phone
(630) 346-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038009968 IL Primary

Addresses

Primary practice location

1361 Pheasant TRL
Hampshire, IL 60140-7413

Mailing address

1361 Pheasant TRL
Hampshire, IL 60140-7413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120803000753 IL Part B Supplier - Clinic/Group Practice 7810143070 Receives reassigned benefits from 1 practitioner
Practice locations: West Dundee, IL

National Provider Directory

National Provider Directory

Locations

999 W Main St
Ste 100
West Dundee, IL 60118
Phone (224) 535-8707

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1295002152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 PHEASANT TRL",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601407413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 PHEASANT TRL",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601407413",
            "telephone_number": "630-346-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO CHIROPRACTIC GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-346-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampshire, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.