Individual provider Active NPI

Christopher Lee Doersam, D.C.

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1396987335
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011294 Issued in IL
Practice address
2712 Forgue Dr Ste 100
Naperville, IL 60564-4230
Phone
(630) 922-7777
NPI assigned
Apr 6, 2009
Last updated
Apr 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011294 IL Primary

Addresses

Primary practice location

2712 Forgue Dr Ste 100
Naperville, IL 60564-4230

Mailing address

2712 Forgue Dr Ste 100
Naperville, IL 60564-4230
Phone (630) 922-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131011000607 IL Practitioner - Chiropractic 4981838646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolve Chiropractic Naperville PLLCGroup PAC ID 1951800317, 2 clinicians

Practice addresses (Care Compare)

1811 Freedom Dr
Suite 117
Naperville, IL 60563-5703
Phone (847) 802-1824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011294ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitney Chiropractic LLC PastSince Apr 25, 2019 Accepting new patients
Naperville Integrative Medicine SC PastSince Oct 1, 2015 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1396987335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 FORGUE DR STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644230",
            "telephone_number": "630-922-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 FORGUE DR STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644230",
            "telephone_number": "630-922-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERSAM",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.