Individual provider Active NPI

James Ian McCrackan, DC

  • Chiropractor
  • Evanston, IL
National Provider Identifier
1619390416
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012520 Issued in IL
Practice address
708 Church St Ste 204
Evanston, IL 60201-3881
Phone
(847) 401-1667
Fax
(270) 837-1518
NPI assigned
Jan 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012520 IL Primary

Addresses

Primary practice location

708 Church St Ste 204
Evanston, IL 60201-3881

Mailing address

708 Church St Ste 204
Evanston, IL 60201-3881
Phone (847) 401-1667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200603001406 IL Practitioner - Chiropractic 3274954060 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012520ILMDChiropractor

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": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1619390416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 204",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013881",
            "telephone_number": "847-401-1667",
            "fax_number": "270-837-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 204",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013881",
            "telephone_number": "847-401-1667",
            "fax_number": "270-837-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKAN",
        "first_name": "JAMES",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.