Jacob Lombardi Mammosser, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.013958 Issued in IL

Practice address

3070 Wolf Rd
Westchester, IL 60154-5622

Phone

(708) 223-8494

Fax

(708) 731-3908

NPI assigned

Jan 30, 2023

Last updated

Jan 30, 2023By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Petrak Family Chiropractic Center S.C

  • Chiropractor
  • Westchester, IL
  • NPI 1841661774
  Medicare reassignment NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1306552559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545622",
            "telephone_number": "708-223-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 WOLF RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545622",
            "telephone_number": "708-223-8494",
            "fax_number": "708-731-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMOSSER",
        "first_name": "JACOB",
        "middle_name": "LOMBARDI",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M & M Counseling
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• Rana F Mafee, M.D.
• Magnastaff, LLC (Magna Home Care)
• Marianjoy Rehabilitation Hospital (CRS Rehabiliation Specialists)
• Peter Joseph Marra, DPT
• Stephen G Marshall, DDS
• Joy Gunther McDowell, M.S.
• Katherine Marie McGee, R.N., B.S.N

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.