Physicians Plus Berwyn LTD.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

038009369 Issued in IL

Legal business name

PHYSICIANS PLUS BERWYN LTD.

Practice address

205 W Randolph St
1205
Chicago, IL 60606-1867

Phone

(312) 265-6908

Fax

(312) 264-0347

NPI assigned

Jan 3, 2008

Last updated

Jun 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott Spencer, D.C.NPI 1679620306

Title

Chiropractic Physician

Phone

(312) 265-6908

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Scott Jason Spencer, D.C.

  • Sports Physician Chiropractor
  • Chicago, IL
  • NPI 1679620306
  Authorized official Same address or phone

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1578748034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "1205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-265-6908",
            "fax_number": "312-264-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "1205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-265-6908",
            "fax_number": "312-264-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS PLUS BERWYN LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "312-265-6908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038009369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01629928",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009369",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Physician Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.