Active NPI
Jessica L Nelson, D.C.
- Chiropractor
- Chicago, IL
National Provider Identifier
1487956306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038011741
- Practice address
- 3055 W Armitage Ave
Chicago, IL 60647-3862 - Phone
- (773) 767-3822
- Fax
- (773) 767-3944
- NPI assigned
- Nov 29, 2010
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038011741 | IL | Primary |
Addresses
Primary practice location
3055 W Armitage Ave
Chicago, IL 60647-3862
Mailing address
3055 W Armitage Ave
Chicago, IL 60647-3862
Phone (773) 767-3822
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038011741 | Other | IL | ILLINOIS STATE LICENSE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 038011741 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1487956306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3055 W ARMITAGE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606473862",
"telephone_number": "773-767-3822",
"fax_number": "773-767-3944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 W ARMITAGE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606473862",
"telephone_number": "773-767-3822",
"fax_number": "773-767-3944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038011741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS STATE LICENSE #",
"identifier": "038011741",
"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 Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.