Hergesheimer Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006399 Issued in IL

Legal business name

HERGESHEIMER CHIROPRACTIC PC

Practice address

8605 W Cermak Rd
North Riverside, IL 60546-1225

Phone

(708) 447-3695

Fax

(708) 447-8733

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Paul Hergesheimer, DCNPI 1275603425

Title

President

Phone

(708) 447-3695

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 5TH AVENUE CHIROPRACTIC CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Michael P. Hergesheimer, D.C.

  • Chiropractor
  • North Riverside, IL
  • NPI 1275603425
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1386799120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461225",
            "telephone_number": "708-447-3695",
            "fax_number": "708-447-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8605 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461225",
            "telephone_number": "708-447-3695",
            "fax_number": "708-447-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERGESHEIMER CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "HERGESHEIMER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-447-3695",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01618882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5TH AVENUE CHIROPRACTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "5TH AVENUE CHIROPRACTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Ellen Gruszka, MD
• Guadalupe Guzman, PHARM,D.
• Emily Halvorson
• Debbie Denean Haymon, OT
• Phoenix Ariel Henry
• Michael P. Hergesheimer, D.C.
• Howard Family Chiropractic, Inc.
• Brandy Howard, D.C.
• Amy Elizabeth Hyttinen, DDS
• Anne Janota, OTR/L

• Chiropractor in North Riverside, IL
• Providers in North Riverside, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.