Organization Active NPI

Evolve Chiropractic Cumberland PLLC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1629713698
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EVOLVE CHIROPRACTIC CUMBERLAND PLLC
Practice address
8600 W Bryn Mawr Ave Ste 100N
Chicago, IL 60631-3544
Phone
(847) 802-4824
NPI assigned
May 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Scott Cruse, DCNPI 1003103938
Title
Owner
Phone
(224) 250-3526

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

8600 W Bryn Mawr Ave Ste 100N
Chicago, IL 60631-3544

Mailing address

10705 Ruth Rd
Huntley, IL 60142-7156
Phone (847) 802-4824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220711001517 IL Part B Supplier - Clinic/Group Practice 2062892813 Receives reassigned benefits from 8 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

8600 W Bryn Mawr Ave
Ste 100N
Chicago, IL 60631
Phone (773) 930-4031

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1629713698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10705 RUTH RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601427156",
            "telephone_number": "847-802-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 W BRYN MAWR AVE STE 100N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313544",
            "telephone_number": "847-802-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE CHIROPRACTIC CUMBERLAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-03",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "CRUSE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-250-3526",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 27, 2024; 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.