Individual provider Active NPI

Brandon P Kolaski, D.C.

  • Chiropractor
  • Glenview, IL
National Provider Identifier
1548327729
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.007885 Issued in IL
Practice address
3412 Henley St
Glenview, IL 60025-3910
Phone
(847) 724-2273
NPI assigned
Jan 3, 2007
Last updated
Oct 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-007885 IL
Chiropractor 111N00000X 038.007885 IL Primary

Addresses

Primary practice location

3412 Henley St
Glenview, IL 60025-3910

Mailing address

3412 Henley St
Glenview, IL 60025-3910
Phone (847) 724-2273

Other practice location 1

333 Waukegan Rd.
Suite D
Glenview, IL 60025
Phone (847) 724-2273

Other identifiers 1

IdentifierTypeStateIssuer
01632069OtherILBCBS PROVIDER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000123 IL Practitioner - Chiropractic 8820065212 Practice locations: Glenview, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3412 Henley St
Glenview, IL 60025-3910
Phone (847) 724-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007885ILMDChiropractor
038.007885ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
First Health Assocates, SC Chiropractor PastSince Nov 13, 2000 Accepting new patients
Firstcare Medical Center, PC PastSince Jul 1, 2025 Accepting new patients
Firstcare Medical Center, PC Past Accepting new patients

Organizations & group practices 3

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1548327729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 HENLEY ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253910",
            "telephone_number": "847-724-2273",
            "fax_number": "847-724-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 HENLEY ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253910",
            "telephone_number": "847-724-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Waukegan Rd.",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "60025",
            "country_code": "US",
            "telephone_number": "847-724-2273",
            "fax_number": "847-724-2724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLASKI",
        "first_name": "BRANDON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-007885",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.007885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "01632069",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.