Individual provider Active NPI

Irshad Kassim

  • Chiropractor
  • Streamwood, IL
National Provider Identifier
1336234970
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009635 Issued in IL
Practice address
180 N Barrington Rd
Streamwood, IL 60107
Phone
(630) 483-8920
Fax
(630) 483-8930
NPI assigned
Oct 3, 2006
Last updated
Jul 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009635 IL Primary

Addresses

Primary practice location

180 N Barrington Rd
Streamwood, IL 60107

Mailing address

180 N Barrington Rd
Streamwood, IL 60107
Phone (630) 483-8920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120321000300 IL Practitioner - Chiropractic 5597925040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

180 N Barrington Rd
Streamwood, IL 60107-1966
Phone (630) 483-8920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009635ILMDChiropractor

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1336234970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N BARRINGTON RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "60107",
            "telephone_number": "630-483-8920",
            "fax_number": "630-483-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N BARRINGTON RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "60107",
            "telephone_number": "630-483-8920",
            "fax_number": "630-483-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "IRSHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.