Individual provider Active NPI

Clifford Lyle Kearns, D.C.

  • Chiropractor
  • Schaumburg, IL
National Provider Identifier
1598854705
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006247 Issued in IL
Practice address
2201 W Schaumburg Rd
Schaumburg, IL 60194-3891
Phone
(847) 301-8585
Fax
(847) 301-8582
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006247 IL Primary

Addresses

Primary practice location

2201 W Schaumburg Rd
Schaumburg, IL 60194-3891

Mailing address

2201 W Schaumburg Rd
Schaumburg, IL 60194-3891
Phone (847) 301-8585

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206001236 IL Practitioner - Chiropractic 7911892286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2201 W Schaumburg Rd
Schaumburg, IL 60194-3891
Phone (708) 307-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Health LTD CurrentSince Jun 1, 1993 Accepting new patients

Locations

2201 W Schaumburg Rd
Schaumburg, IL 60194
Phone (708) 307-8585

2201 W Schaumburg Rd
Ste A
Schaumburg, IL 60194

Organizations & group practices 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1598854705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W SCHAUMBURG RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601943891",
            "telephone_number": "847-301-8585",
            "fax_number": "847-301-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W SCHAUMBURG RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601943891",
            "telephone_number": "847-301-8585",
            "fax_number": "847-301-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "CLIFFORD",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.