Individual provider Active NPI

Panagiota Betty Stasinos, D.C.

  • Chiropractor
  • Park Ridge, IL
National Provider Identifier
1467577056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
2104 Oakton St
Park Ridge, IL 60068-1820
Phone
(847) 692-6956
Fax
(847) 692-9651
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

2104 Oakton St
Park Ridge, IL 60068-1820

Mailing address

5506 N Canfield Ave
Chicago, IL 60656-1637
Phone (708) 609-2123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000884 IL Practitioner - Chiropractic 8224048210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Health LTDGroup PAC ID 2567609027, 2 clinicians

Practice addresses (Care Compare)

1550 N Northwest Hwy
Suite 206
Park Ridge, IL 60068-1459
Phone (847) 739-3120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health LTD Chiropractor CurrentSince Oct 31, 2019 Accepting new patients
Korwitts Chiropractic PC Chiropractor PastSince Mar 1, 2005 Accepting new patients

Locations

1550 N Northwest Hwy
Ste 206
Park Ridge, IL 60068
Phone (847) 739-3120

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467577056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 N CANFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561637",
            "telephone_number": "708-609-2123",
            "fax_number": "708-867-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 OAKTON ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681820",
            "telephone_number": "847-692-6956",
            "fax_number": "847-692-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASINOS",
        "first_name": "PANAGIOTA",
        "middle_name": "BETTY",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.