Individual provider Active NPI

Patricia Marie Wasco, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1629081930
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
5356 W Addison St
Chicago, IL 60641-3356
Phone
(773) 283-4700
Fax
(773) 283-4848
NPI assigned
Aug 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

5356 W Addison St
Chicago, IL 60641-3356

Mailing address

5356 W Addison St
Chicago, IL 60641-3356
Phone (773) 283-4700

Other identifiers 1

IdentifierTypeStateIssuer
1627562OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080927000266 IL Practitioner - Chiropractic 8123195443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5356 W Addison St
Chicago, IL 60641-3356
Phone (773) 283-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009263ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spinal Clinic P.C. Chiropractor CurrentSince Dec 31, 2010 Accepting new patients
Illinois Medical Group SC Past Accepting new patients

Locations

5356 W Addison St
Chicago, IL 60641
Phone (773) 283-4700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629081930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5356 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413356",
            "telephone_number": "773-283-4700",
            "fax_number": "773-283-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413356",
            "telephone_number": "773-283-4700",
            "fax_number": "773-283-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASCO",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1627562",
            "state": "IL"
        }
    ],
    "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 Jul 8, 2007; 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.