Individual provider Active NPI

Joshua Knicker

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1548877301
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013590 Issued in IL
Practice address
3360 Lacrosse LN Ste 116
Naperville, IL 60564-8155
Phone
(630) 904-9700
NPI assigned
Sep 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013590 IL Primary

Addresses

Primary practice location

3360 Lacrosse LN Ste 116
Naperville, IL 60564-8155

Mailing address

3360 Lacrosse LN Ste 116
Naperville, IL 60564-8155
Phone (630) 904-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201215001801 IL Practitioner - Chiropractic 3870905912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifeclinic Chiropractic of Illinois LLCGroup PAC ID 1153600648, 6 clinicians

Practice addresses (Care Compare)

1220 Lakeview Dr
Romeoville, IL 60446-3901
Phone (630) 759-9995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013590ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeclinic Chiropractic of Illinois LLC Chiropractor CurrentSince May 6, 2023 Accepting new patients
Illinois Spinal & Sports Rehabilitation SC Chiropractor CurrentSince Dec 1, 2020 Accepting new patients

Locations

3360 Lacrosse Ln
Ste 116
Naperville, IL 60564
Phone (630) 848-9372

1220 Lakeview Dr
Romeoville, IL 60446
Phone (630) 536-9077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1548877301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 LACROSSE LN STE 116",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648155",
            "telephone_number": "630-904-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 LACROSSE LN STE 116",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648155",
            "telephone_number": "630-904-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKER",
        "first_name": "JOSHUA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.