Organization Active NPI

Chiropractic Physicians of Wicker Park Co

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1588052815
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012742 Issued in IL
Legal business name
CHIROPRACTIC PHYSICIANS OF WICKER PARK CO
Practice address
1635 N Ashland Ave
Chicago, IL 60622-1423
Phone
(773) 360-8108
NPI assigned
Jan 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Authorized official

Name
Dr. Martin Karwowski, DDS
Title
Owner/President
Phone
(773) 631-6106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038012742 IL Primary

Addresses

Primary practice location

1635 N Ashland Ave
Chicago, IL 60622-1423

Mailing address

1635 N Ashland Ave
Chicago, IL 60622-1423
Phone (773) 360-8108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190312003093 IL Part B Supplier - Clinic/Group Practice 8527389659 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

3324 W Diversey Ave
Chicago, IL 60647
Phone (773) 360-8108

1616 Ogden Ave
Lisle, IL 60532
Phone (630) 226-0220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1588052815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221423",
            "telephone_number": "773-360-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221423",
            "telephone_number": "773-360-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC PHYSICIANS OF WICKER PARK CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "KARWOWSKI",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "773-631-6106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.