Active NPI
Robert Fenton, D.C.
- Chiropractor
- Chicago, IL
National Provider Identifier
1467895953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038012378
- Practice address
- 121 W Chestnut St
Apt. 3004
Chicago, IL 60610-3175 - Phone
- (847) 644-0696
- NPI assigned
- Apr 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038012378 | IL | Primary |
Addresses
Primary practice location
121 W Chestnut St
Apt. 3004
Chicago, IL 60610-3175
Mailing address
121 W Chestnut St
Apt. 3004
Chicago, IL 60610-3175
Phone (847) 644-0696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131003000024 | IL | Practitioner - Chiropractic | 6507090693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038012378 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365984000000",
"number": "1467895953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 W CHESTNUT ST",
"address_2": "APT. 3004",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606103175",
"telephone_number": "847-644-0696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 W CHESTNUT ST",
"address_2": "APT. 3004",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606103175",
"telephone_number": "847-644-0696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENTON",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-15",
"last_updated": "2013-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038012378",
"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 Apr 15, 2013; 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.