NPIMap

Organization Active NPI

Blue Island Traditional Medicine, LLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1386144665
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLUE ISLAND TRADITIONAL MEDICINE, LLC
Practice address
1843 S Racine Ave
Chicago, IL 60608-3213
Phone
(773) 332-9438
NPI assigned
Feb 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Beatrice ScesckeNPI 1740789387
Title
Owner
Phone
(312) 291-8298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 1980011282 IL
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X 227014734 IL

Addresses

Primary practice location

1843 S Racine Ave
Chicago, IL 60608-3213

Mailing address

1843 S Racine Ave
Chicago, IL 60608-3213
Phone (773) 332-9438

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1386144665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 S RACINE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083213",
            "telephone_number": "773-332-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 S RACINE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083213",
            "telephone_number": "773-332-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ISLAND TRADITIONAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "SCESCKE",
        "authorized_official_first_name": "BEATRICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-291-8298"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "1980011282",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227014734",
            "primary": false
        }
    ],
    "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 Jun 18, 2019; 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.