Organization Active NPI

Greenwood Spine Care PLLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1528521341
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GREENWOOD SPINE CARE PLLC
Practice address
11001 S Kedzie Ave
Chicago, IL 60655-2221
Phone
(773) 585-5550
Fax
(773) 585-1061
NPI assigned
Apr 9, 2019
Last updated
Apr 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Authorized official

Name
Dr. Michael William Hausch, DCNPI 1972791184
Title
Coo
Phone
(630) 200-1050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

11001 S Kedzie Ave
Chicago, IL 60655-2221

Mailing address

11001 S Kedzie Ave
Chicago, IL 60655-2221
Phone (773) 585-5550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191024001903 IL Part B Supplier - Clinic/Group Practice 7012249055 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1528521341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552221",
            "telephone_number": "773-585-5550",
            "fax_number": "773-585-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 S KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552221",
            "telephone_number": "773-585-5550",
            "fax_number": "773-585-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD SPINE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "HAUSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-200-1050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "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 9, 2019; 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.

Verify at the official NPI Registry.