Individual provider Active NPI

Shanna C Fritsch, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1336213149
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010678 Issued in IL
Practice address
65 E Wacker PL
Suite 1615
Chicago, IL 60601-7296
Phone
(815) 793-2951
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010678 IL Primary

Addresses

Primary practice location

65 E Wacker PL
Suite 1615
Chicago, IL 60601-7296

Mailing address

2556 W Cortland St
2F
Chicago, IL 60647-4370
Phone (815) 793-2951

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080902000339 IL Practitioner - Chiropractic 9931275740 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010678ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Holistic, LLC Chiropractor CurrentSince Dec 27, 2018 Accepting new patients

Locations

111 N Wabash Ave
Ste 1414
Chicago, IL 60602
Phone (312) 634-0740

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1336213149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2556 W CORTLAND ST",
            "address_2": "2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474370",
            "telephone_number": "815-793-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E WACKER PL",
            "address_2": "SUITE 1615",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017296",
            "telephone_number": "815-793-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITSCH",
        "first_name": "SHANNA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.