Peter S. Petrovas D.C. L.T.D.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

111N00000X Issued in IL

Legal business name

PETER S. PETROVAS D.C. L.T.D.

Practice address

5962 N Lincoln Ave
Suite 12
Chicago, IL 60659-3711

Phone

(773) 989-4305

Fax

(773) 989-7450

NPI assigned

Jul 28, 2009

Organization subpart

Yes

Parent organization

PETER S. PETROVAS D.C. L.T.D.As reported in NPPES

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

Authorized official

Name

Dr. Peter Steven Petrovas, D.C.NPI 1306825682

Title

Owner

Phone

(773) 989-4305

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Peter S Petrovas DC LTD

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter S Petrovas, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1306825682
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1346471257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5962 N LINCOLN AVE",
            "address_2": "SUITE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593711",
            "telephone_number": "773-989-4305",
            "fax_number": "773-989-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5962 N LINCOLN AVE",
            "address_2": "SUITE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593711",
            "telephone_number": "773-989-4305",
            "fax_number": "773-989-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER S. PETROVAS D.C. L.T.D.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PETER S. PETROVAS D.C. L.T.D.",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "PETROVAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "17739894305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "111N00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.