Individual provider Active NPI

Sandra Sue Schwartz, DC

  • Chiropractor
  • Champaign, IL
National Provider Identifier
1295915221
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004290 Issued in IL
Practice address
1401B South State Street
Champaign, IL 61820-6877
Phone
(217) 351-2021
Fax
(217) 351-1740
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 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 038004290 IL Primary

Addresses

Primary practice location

1401B South State Street
Champaign, IL 61820-6877

Mailing address

1401B South State Street
Champaign, IL 61820-6877
Phone (217) 351-2021

Other identifiers 1

IdentifierTypeStateIssuer
1015000OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Familia First Health NFP CurrentSince Jul 1, 2024 Accepting new patients

Locations

1401 S State St
Ste B
Champaign, IL 61820
Phone (217) 351-2021

Organizations & group practices 1

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1295915221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401B SOUTH STATE STREET",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206877",
            "telephone_number": "217-351-2021",
            "fax_number": "217-351-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401B SOUTH STATE STREET",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206877",
            "telephone_number": "217-351-2021",
            "fax_number": "217-351-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "SANDRA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1015000",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.