Individual provider Active NPI

Alex Kazimier Swanson, DC

  • Chiropractor
  • Crystal Lake, IL
National Provider Identifier
1316411077
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60909536 Issued in WA
Practice address
407 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6238
Phone
(847) 987-5085
NPI assigned
Jan 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH60909536 WA Primary

Addresses

Primary practice location

407 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6238

Mailing address

407 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6238
Phone (847) 987-5085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115000220 IL Practitioner - Chiropractic 1355689530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
May accept Medicare assignment
Group practices
A to Z Chiropractic SCGroup PAC ID 9537428172, 3 clinicians

Practice addresses (Care Compare)

407 E Congress Pkwy
Suite C
Crystal Lake, IL 60014-6238
Phone (847) 987-5085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A to Z Chiropractic SC Chiropractor CurrentSince Jan 2, 2024 Accepting new patients

Locations

411 E Congress Pkwy
Ste C
Crystal Lake, IL 60014
Phone (815) 455-8213

407 E Congress Pkwy
Ste C
Crystal Lake, IL 60014
Phone (847) 987-5085

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1316411077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E CONGRESS PKWY STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146238",
            "telephone_number": "847-987-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E CONGRESS PKWY STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146238",
            "telephone_number": "847-987-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "ALEX",
        "middle_name": "KAZIMIER",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60909536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.