Jason Wayne Ingham, DC, CCSP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038008978 Issued in IL

Practice address

2828 N Clark St
Chicago, IL 60657-5775

Phone

(773) 868-0347

Fax

(773) 868-0401

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jason W Ingham DC SC

  • Sports Physician Chiropractor
  • Chicago, IL
  • NPI 1992982664
  NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1295835445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575775",
            "telephone_number": "773-868-0347",
            "fax_number": "773-868-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575775",
            "telephone_number": "773-868-0347",
            "fax_number": "773-868-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGHAM",
        "first_name": "JASON",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DC, CCSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008978",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038-008978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "01626851",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Ingalls, M.D.
• Halimatu Sadiyya Ingawa
• Thomas Inge, MD
• Amy Ingeneri, MD
• Betty N Ingente, PHARMACIST
• Katherine A Ingle, RD
• Amy Clare Ingraffia, ATC
• Melissa Vastoria Ingraham Pickens
• Brooke Alexis Ingraham
• Britany Ingram

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.