Active NPI
Brandon P Kolaski, D.C.
- Chiropractor
- Glenview, IL
National Provider Identifier
1548327729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.007885
- Practice address
- 3412 Henley St
Glenview, IL 60025-3910 - Phone
- (847) 724-2273
- NPI assigned
- Jan 3, 2007
- Last updated
- Oct 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01632069 | Other | IL | BCBS PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 038-007885 | IL | MD | Chiropractor |
| 038.007885 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Health Assocates, SC | Chiropractor | Past | Accepting new patients |
| Firstcare Medical Center, PC | Past | 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.
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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.