Individual provider Active NPI

Christine Ting-Fu Pan, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1386822435
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011095 Issued in IL
Practice address
111 N Wabash Ave
Ste 1414
Chicago, IL 60602-3070
Phone
(312) 634-0740
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011095 IL Primary

Addresses

Primary practice location

111 N Wabash Ave
Ste 1414
Chicago, IL 60602-3070

Mailing address

111 N Wabash Ave
Ste 1414
Chicago, IL 60602-3070
Phone (773) 840-2556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011095ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Centered Holistic, LLC Chiropractor CurrentSince Dec 27, 2018 Accepting new patients

Locations

111 N Wabash Ave
Ste 1414
Chicago, IL 60602
Phone (312) 634-0740

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": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1386822435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "STE 1414",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023070",
            "telephone_number": "773-840-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "STE 1414",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023070",
            "telephone_number": "312-634-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "CHRISTINE",
        "middle_name": "TING-FU",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011095",
            "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 Apr 17, 2017; 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.