Individual provider Active NPI

Anne I. Gordon, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1366461006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
30 S Michigan Ave
Ste 400
Chicago, IL 60603-3211
Phone
(312) 726-1353
Fax
(312) 726-5238
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

30 S Michigan Ave
Ste 400
Chicago, IL 60603-3211

Mailing address

30 S Michigan Ave
Ste 400
Chicago, IL 60603-3211
Phone (312) 726-1353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123001053 IL Practitioner - Chiropractic 7315133840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National University of Arts and Sciences, Medical Department, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 S Michigan Ave
Suite 400
Chicago, IL 60603-3222
Phone (312) 726-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038006815ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Chiropractic Center, S.C. Chiropractor CurrentSince Dec 1, 2010 Accepting new patients
Chicago Physical Therapy & Rehabilitation Past Accepting new patients
Chicago Physical Therapy & Rehabilitation Center, Inc. PastSince Jun 1, 2017 Accepting new patients

Locations

30 S Michigan Ave
Ste 400
Chicago, IL 60603
Phone (312) 422-0042

Organizations & group practices 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366461006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S MICHIGAN AVE",
            "address_2": "STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033211",
            "telephone_number": "312-726-1353",
            "fax_number": "312-726-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S MICHIGAN AVE",
            "address_2": "STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033211",
            "telephone_number": "312-726-1353",
            "fax_number": "312-726-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANNE",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "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 Jul 8, 2007; 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.