Evan Soutter, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038013891 Issued in IL

Practice address

1749 N Wells St
Chicago, IL 60614-5877

Phone

(312) 440-9646

Fax

(773) 337-9106

NPI assigned

Aug 30, 2022

Last updated

Aug 31, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wicker Park Spine and Stability, LLCGroup PAC ID 3274915988, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wicker Park Spine and Stability, LLC

  • Chiropractor
  • Chicago, IL
  • NPI 1184370538
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1376263459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 N WELLS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145877",
            "telephone_number": "312-440-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 N WELLS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145877",
            "telephone_number": "312-440-9646",
            "fax_number": "773-337-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTTER",
        "first_name": "EVAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "038013891",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE PROVIDER LICENSE",
            "identifier": "03803891",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southwest Optometric Associates P C (Miami Optical)
• Southwest Senior Center
• Southwest Smiling Dental P.C.
• Southworth Therapy LLC
• Jillian Morrison Southworth, LCSW
• Jacqueline Souza, MD
• Jamie Frances Sovcik, PHARMD
• Paul Sovcik, PHARMD
• Austin Timothy Sovell
• Sovereign Healthcare

• 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 Aug 31, 2022; 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.