Individual provider Active NPI

Daniel Vincent Fortuna, D.C.

  • Chiropractor
  • Berwyn, IL
National Provider Identifier
1538325048
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009315 Issued in IL
Practice address
2947 Oak Park Ave
Berwyn, IL 60402-3048
Phone
(708) 749-0606
Fax
(708) 749-7793
NPI assigned
Aug 4, 2008
Last updated
Aug 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038009315 IL Primary

Addresses

Primary practice location

2947 Oak Park Ave
Berwyn, IL 60402-3048

Mailing address

2947 Oak Park Ave
Berwyn, IL 60402-3048
Phone (708) 749-0606

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038009315ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Young Men's Christian Association of Berwyn-Cicero PastSince May 23, 2014 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1538325048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2947 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023048",
            "telephone_number": "708-749-0606",
            "fax_number": "708-749-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2947 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023048",
            "telephone_number": "708-749-0606",
            "fax_number": "708-749-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "DANIEL",
        "middle_name": "VINCENT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.