Organization Active NPI

Chiropractic Medicine & Associates of Dupage

  • Occupational Health Chiropractor
  • Wheaton, IL
National Provider Identifier
1508071135
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
038003478 Issued in IL
Legal business name
CHIROPRACTIC MEDICINE & ASSOCIATES OF DUPAGE
Practice address
1600 N Main St
Wheaton, IL 60187-3145
Phone
(630) 510-7774
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
Dr. Franklin W. Forman, DC
Title
President
Phone
(630) 510-7774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0100X 038003478 IL Primary

Addresses

Primary practice location

1600 N Main St
Wheaton, IL 60187-3145

Mailing address

1984 Spring Green Dr
Wheaton, IL 60187-7254
Phone (630) 510-7774

Other identifiers 2

IdentifierTypeStateIssuer
1548351216OtherNATIONAL PROV TYPE 1 ID
2290080OtherILIL BCBS NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1508071135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1984 SPRING GREEN DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601877254",
            "telephone_number": "630-510-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873145",
            "telephone_number": "630-510-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC MEDICINE & ASSOCIATES OF DUPAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-510-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "IL",
            "license": "038003478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROV TYPE 1 ID",
            "identifier": "1548351216",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BCBS NUMBER",
            "identifier": "2290080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.