Kenneth Mark Sistino, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006195 Issued in IL

Practice address

2229 W Chicago Ave
Chicago, IL 60622-4828

Phone

(773) 862-4500

Fax

(773) 862-4517

NPI assigned

Sep 24, 2011

Last updated

Sep 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affiliated Health Care Associates

  • Rehabilitation Chiropractor
  • Chicago, IL
  • NPI 1326165135
  NPD (past)
• Bassam Osman, MD, SC, LTD

  • Neurology Physician
  • Chicago, IL
  • NPI 1245437839
  NPD (past)

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1508149691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224828",
            "telephone_number": "773-862-4500",
            "fax_number": "773-862-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224828",
            "telephone_number": "773-862-4500",
            "fax_number": "773-862-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTINO",
        "first_name": "KENNETH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan L. Sisson, M.D.
• George Sisson Jr., MD
• Sista Afya Community Care NFP
• Sista Afya Community Care NFP
• Sista Afya Community Mental Wellness LLC
• Amy Siston, PH.D.
• Charles Sisung, MD
• Dorothy K. Sit, M.D.
• Phyllis Marie Sit, APN, CRNA
• Teresa Sit, LPC, ATR

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.