NPIMap

Organization Active NPI

Integrated Chiropractic of the North Shore LLC

  • Chiropractor
  • Northbrook, IL
National Provider Identifier
1639148307
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009467 Issued in IL
Legal business name
INTEGRATED CHIROPRACTIC OF THE NORTH SHORE LLC
Practice address
666 Dundee Rd
Suite 307
Northbrook, IL 60062-2727
Phone
(847) 897-8888
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Authorized official

Name
Mark Grumet, DC
Title
Owner
Phone
(847) 897-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038-009467 IL Primary

Addresses

Primary practice location

666 Dundee Rd
Suite 307
Northbrook, IL 60062-2727

Mailing address

666 Dundee Rd
Suite 307
Northbrook, IL 60062-2727
Phone (847) 897-8888

Other identifiers 1

IdentifierTypeStateIssuer
01628196OtherILBCBSIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1639148307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 307",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-897-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD",
            "address_2": "SUITE 307",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622727",
            "telephone_number": "847-897-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CHIROPRACTIC OF THE NORTH SHORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "GRUMET",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-897-8888",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "01628196",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.