Individual provider Active NPI

Christopher Kirkwood Edginton, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1417919333
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009577 Issued in IL
Practice address
122 S Michigan Ave Ste 1265
Chicago, IL 60603-6200
Phone
(312) 939-4121
Fax
(312) 939-8011
NPI assigned
Apr 5, 2006
Last updated
Oct 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-009577 IL Primary

Addresses

Primary practice location

122 S Michigan Ave Ste 1265
Chicago, IL 60603-6200

Mailing address

122 S Michigan Ave Ste 1265
Chicago, IL 60603-6200
Phone (312) 939-4121

Other practice location 1

6524 W Archer Ave
Chicago, IL 60638-2400
Phone (773) 229-9600

Other identifiers 1

IdentifierTypeStateIssuer
038009577MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000135 IL Practitioner - Chiropractic 5698753440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

122 S Michigan Ave
Suite 1265
Chicago, IL 60603-6200
Phone (312) 939-4121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009577ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Millenium Park Medical Center, SC Chiropractor CurrentSince Feb 1, 2015 Accepting new patients

Locations

122 S Michigan Ave
Ste 1265
Chicago, IL 60603
Phone (312) 939-4121

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, 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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1417919333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE STE 1265",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036200",
            "telephone_number": "312-939-4121",
            "fax_number": "312-939-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MICHIGAN AVE STE 1265",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036200",
            "telephone_number": "312-939-4121",
            "fax_number": "312-939-8011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6524 W Archer Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606382400",
            "country_code": "US",
            "telephone_number": "773-229-9600",
            "fax_number": "773-229-9611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGINTON",
        "first_name": "CHRISTOPHER",
        "middle_name": "KIRKWOOD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009577",
            "state": "IL"
        }
    ],
    "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 Oct 15, 2020; 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.