Active NPI
Pamela A Ballard, DC
- Rehabilitation Chiropractor
- Medinah, IL
National Provider Identifier
1457576621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 038-006728
- Practice address
- 7N315 Sycamore Ave
Medinah, IL 60157-9799 - Phone
- (630) 307-7463
- Fax
- (630) 529-0087
- NPI assigned
- Apr 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 038-006728 | IL | Primary |
Addresses
Primary practice location
7N315 Sycamore Ave
Medinah, IL 60157-9799
Mailing address
PO Box 460
Medinah, IL 60157-0460
Phone (630) 529-0077
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02232227 | Other | IL | BLUECROSS BLUESHIELD |
| 208982 | Other | IL | MEDICARE GROUP NO. |
| 038006728 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 038-006728 | IL | MD | Rehabilitation Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Xray | Past | Accepting new patients |
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.
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Medinah, IL
- NPI 1467590471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1457576621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 460",
"city": "MEDINAH",
"state": "IL",
"postal_code": "601570460",
"telephone_number": "630-529-0077",
"fax_number": "630-529-0087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7N315 SYCAMORE AVE",
"city": "MEDINAH",
"state": "IL",
"postal_code": "601579799",
"telephone_number": "630-307-7463",
"fax_number": "630-529-0087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLARD",
"first_name": "PAMELA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-14",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "IL",
"license": "038-006728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "02232227",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NO.",
"identifier": "208982",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038006728",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medinah, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.