Active NPI
Valerian Kravtsov, D.C.
- Internist Chiropractor
- Des Plaines, IL
National Provider Identifier
1629113709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- Practice address
- 1645 S Des Plaines River Rd
Suite 14
Des Plaines, IL 60018 - Phone
- (847) 361-4971
- Fax
- (847) 296-2922
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | IL | Primary |
Addresses
Primary practice location
1645 S Des Plaines River Rd
Suite 14
Des Plaines, IL 60018
Mailing address
1800 Ridge Ave
#203
Evanston, IL 60201-3696
Phone (847) 361-4971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1622831 | Other | IL | BCBS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-38008582 | IL | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1629113709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 RIDGE AVE",
"address_2": "#203",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602013696",
"telephone_number": "847-361-4971",
"fax_number": "847-296-2922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 S DES PLAINES RIVER RD",
"address_2": "SUITE 14",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "60018",
"telephone_number": "847-361-4971",
"fax_number": "847-296-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAVTSOV",
"first_name": "VALERIAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "1622831",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.