Individual provider Active NPI

Miravone Dorough, D.C, N.D

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1477836450
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011893 Issued in IL
Practice address
24W788 75TH St
Naperville, IL 60565-1684
Phone
(331) 442-9912
Fax
(331) 333-1802
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038011893 IL Primary

Addresses

Primary practice location

24W788 75TH St
Naperville, IL 60565-1684

Mailing address

24W788 75TH St
Naperville, IL 60565-1684
Phone (331) 442-9912

Other practice location 1

415 W Golf Rd
Arlington Heights, IL 60005-3929
Phone (847) 981-8803

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038011893ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1477836450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24W788 75TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651684",
            "telephone_number": "331-442-9912",
            "fax_number": "331-333-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24W788 75TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651684",
            "telephone_number": "331-442-9912",
            "fax_number": "331-333-1802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 W Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600053929",
            "country_code": "US",
            "telephone_number": "847-981-8803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOROUGH",
        "first_name": "MIRAVONE",
        "name_prefix": "Dr.",
        "credential": "D.C, N.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2021-08-19",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.