Jason G Fennema, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010696 Issued in IL

Practice address

1806 W Cuyler Ave
Chicago, IL 60613-2402

Phone

(773) 327-2225

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Physical Medicine and Rehabilitation

Education

Logan College of Chiropractic, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Performance Pain and Wellness CenterGroup PAC ID 3577820380, 3 clinicians

Ravenswood Health and Wellness Center S.C.Group PAC ID 2264755099, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advance Performance Pain and Wellness Center

  • Rehabilitation Chiropractor
  • Aurora, IL
  • NPI 1356887475
  Medicare reassignment Care Compare group NPD Authorized official
• Ravenswood Health and Wellness Center, S.C.

  • Rehabilitation Chiropractor
  • Chicago, IL
  • NPI 1093126435
  Medicare reassignment Care Compare group NPD Authorized official
• Ravenswood Health Center, P.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1114116522
  NPD (past) Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1386657690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 W CUYLER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132402",
            "telephone_number": "773-327-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W CUYLER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132402",
            "telephone_number": "773-327-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNEMA",
        "first_name": "JASON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaohua Feng
• Leslie Fenio, PA-C
• Fenix Wellness, PLLC
• Michael Fenlon, M.D.
• Deborah Lynn Fenn, PSYD
• Lariza Fenner-Lux
• Anna Fenner, MD
• Soreida Mamie Fennerr
• Michelle Margaret Fennessy, CNS, APN
• Samantha Mae Fenno, LCSW

• 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 Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.