Bartlett Chiropractic Clinic, SC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038010561 Issued in IL

Legal business name

BARTLETT CHIROPRACTIC CLINIC, SC

Practice address

314 W Rollins Rd
Ste B
Round Lake Beach, IL 60073-1204

Phone

(847) 546-4220

Fax

(847) 546-4262

NPI assigned

Dec 30, 2015

Last updated

Dec 30, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

BARTLETT CHIROPRACTIC CLINIC, SCAs reported in NPPES

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

Authorized official

Name

Dr. Keith Charles Richard, D.C.NPI 1245399054

Title

President

Phone

(321) 795-7497

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bartlett Chiropractic Clinic, S.C.

  • Chiropractor
  • Bartlett, IL
  • NPI 1700132891

  O20121129000584

  Same enrollment

Tax ID family

Bartlett Chiropractic Clinic SC2 organizations share this tax ID, including this one

Part of

Bartlett Chiropractic Clinic SC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bartlett Chiropractic Clinic, S.C.

  • Chiropractor
  • Bartlett, IL
  • NPI 1700132891
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith Charles Richard, D.C.

  • Chiropractor
  • Bartlett, IL
  • NPI 1245399054
  NPD Authorized official
• Daniel Marc Vanderweit, D.C.

  • Chiropractor
  • Round Lake Beach, IL
  • NPI 1588669618
  NPD

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1407211832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W ROLLINS RD",
            "address_2": "STE B",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731204",
            "telephone_number": "847-546-4220",
            "fax_number": "847-546-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W ROLLINS RD",
            "address_2": "STE B",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731204",
            "telephone_number": "847-546-4220",
            "fax_number": "847-546-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT CHIROPRACTIC CLINIC, SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BARTLETT CHIROPRACTIC CLINIC, SC",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-795-7497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mays Husam Al-Saffar
• Noor Aljanabi, DMD
• American Drug Stores LLC (Osco Drug #3432)
• Athletico LTD. (Athletico Physical Therapy)
• August Horizons Counseling LLC
• Lori Beckberger, PHARMD
• Alondra Bejarano
• Donna Marie Beltran, P.T.
• Bruce Chisholm Bennett, D.D.S.
• Anita Rani Bhardwaj, MD

• Chiropractor in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.