Family Tree Chiropractic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012789 Issued in IL

Legal business name

FAMILY TREE CHIROPRACTIC INC

Practice address

1440 Renaissance Dr
Suite 120
Park Ridge, IL 60068-1356

Phone

(847) 403-1101

NPI assigned

May 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Whitney Leigh Fandel, D.C.NPI 1376810614

Title

Owner

Phone

(847) 403-1101

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Whitney Leigh Fandel, D.C.

  • Chiropractor
  • Park Ridge, IL
  • NPI 1376810614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1629455977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681356",
            "telephone_number": "847-403-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681356",
            "telephone_number": "847-403-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY TREE CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "FANDEL",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-403-1101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012789",
            "primary": true
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "IL",
            "license": "038012789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irina Evans, MSN,FNP-BC
• Everest Hospice Inc
• Eye Specialists of Illinois, S.C,
• Fahdora Med LLC
• Zachary Fainman, M.D.
• Whitney Leigh Fandel, D.C.
• Shuyang Fang, MD, MPH
• Michelle Fanning, LCSW
• Syeda Fatima Farheen
• Mark Andrew Fasick

• Chiropractor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.