Individual provider Active NPI

Jodi Heather Kirsch, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1407154446
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011865 Issued in IL
Practice address
212 N Carpenter St
Chicago, IL 60607-1713
Phone
(312) 928-9282
Fax
(312) 588-7211
NPI assigned
Feb 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011865 IL Primary

Addresses

Primary practice location

212 N Carpenter St
Chicago, IL 60607-1713

Mailing address

212 N Carpenter St
Chicago, IL 60607-1713
Phone (312) 928-9282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110512000648 IL Practitioner - Chiropractic 4981880739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wicker Park Spine and Stability, LLCGroup PAC ID 3274915988, 2 clinicians
Jodi H Kirsch DC, LLCGroup PAC ID 0345533220, 3 clinicians

Practice addresses (Care Compare)

1641 -1643 W N Ave
Unit 1
Chicago, IL 60622
Phone (312) 928-9282

212 N Carpenter St
Chicago, IL 60607-1713
Phone (312) 928-9282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011865ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wicker Park Spine and Stability, LLC Chiropractor CurrentSince Nov 21, 2021 Accepting new patients
Jodi H Kirsch DC,LLC Chiropractor CurrentSince May 31, 2016 Accepting new patients

Locations

212 N Carpenter St
Chicago, IL 60607
Phone (312) 928-9282

212 N Carpenter St
Unit A1A2
Chicago, IL 60607

Organizations & group practices 2

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": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1407154446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N CARPENTER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071713",
            "telephone_number": "312-928-9282",
            "fax_number": "312-588-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N CARPENTER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071713",
            "telephone_number": "312-928-9282",
            "fax_number": "312-588-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCH",
        "first_name": "JODI",
        "middle_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-28",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011865",
            "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 Jun 21, 2016; 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.