The Sports Injury Center, LTD.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

THE SPORTS INJURY CENTER, LTD.

Practice address

2654 N Lincoln Ave
Chicago, IL 60614-1307

Phone

(773) 529-4129

Fax

(773) 529-5672

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alden C. Clendenin, D.C.

Title

Owner

Phone

(773) 529-4129

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346377652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141307",
            "telephone_number": "773-529-4129",
            "fax_number": "773-529-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141307",
            "telephone_number": "773-529-4129",
            "fax_number": "773-529-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPORTS INJURY CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "ALDEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-529-4129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.