Individual provider Active NPI

Travis J Ahrens, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1376977769
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38.012838 Issued in IL
Practice address
233 E Wacker Dr
1402
Chicago, IL 60601-5104
Phone
(920) 410-8728
NPI assigned
Aug 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38.012838 IL Primary

Addresses

Primary practice location

233 E Wacker Dr
1402
Chicago, IL 60601-5104

Mailing address

233 E Wacker Dr
1402
Chicago, IL 60601-5104
Phone (920) 410-8728

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001526 IL Practitioner - Chiropractic 5799064333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Evolution Spine and Sports Therapy, LLCGroup PAC ID 1355620998, 2 clinicians

Practice addresses (Care Compare)

922 Noyes St
Evanston, IL 60201-2706
Phone (224) 307-2201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38.012838ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Spine & Sports Therapy, LLC Chiropractor CurrentSince Feb 10, 2016 Accepting new patients

Locations

922 Noyes St
Evanston, IL 60201
Phone (224) 307-2201

Organizations & group practices 1

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": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1376977769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E WACKER DR",
            "address_2": "1402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015104",
            "telephone_number": "920-410-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E WACKER DR",
            "address_2": "1402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015104",
            "telephone_number": "920-410-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHRENS",
        "first_name": "TRAVIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-21",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38.012838",
            "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 Feb 9, 2016; 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.