NPIMap

Organization Active NPI

Gladstone Chiropractic Group LTD

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1376766600
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008327 Issued in IL
Legal business name
GLADSTONE CHIROPRACTIC GROUP LTD
Practice address
5316 B N Milwaukee Avenue
Chicago, IL 60630-1266
Phone
(773) 774-1041
Fax
(773) 774-8541
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Elizabeth Stipisic, DC
Title
Owner
Phone
(773) 774-1041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038008327 IL Primary

Addresses

Primary practice location

5316 B N Milwaukee Avenue
Chicago, IL 60630-1266

Mailing address

5316 B N Milwaukee Avenue
Chicago, IL 60630-1266
Phone (773) 774-1041

Other identifiers 1

IdentifierTypeStateIssuer
1630133OtherILBCBS

National Provider Directory

National Provider Directory

Locations

5316 N Milwaukee Ave
Ste B
Chicago, IL 60630
Phone (773) 774-1041

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1376766600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5316 B N MILWAUKEE AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301266",
            "telephone_number": "773-774-1041",
            "fax_number": "773-774-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 B N MILWAUKEE AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301266",
            "telephone_number": "773-774-1041",
            "fax_number": "773-774-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADSTONE CHIROPRACTIC GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "STIPISIC",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-774-1041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1630133",
            "state": "IL"
        }
    ],
    "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 Jun 24, 2008; 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.