Active NPI
Anita Ann Dickerson, D.C.
- Chiropractor
- St Charles, IL
National Provider Identifier
1639213291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038-010318
- Practice address
- 1434 E Main St
A
Saint Charles, IL 60174-2374 - Phone
- (630) 450-5515
- NPI assigned
- Feb 16, 2007
- Last updated
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-010318 | IL | Primary |
Addresses
Primary practice location
1434 E Main St
A
Saint Charles, IL 60174-2374
Mailing address
1434 E Main St
A
Saint Charles, IL 60174-2374
Phone (630) 450-5515
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-010318 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 41 North Chiropractic & Soft Tissue Clinic, P.C. | Chiropractor | Past | Accepting new patients |
| Finnegan Family Chiropractic LTD | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- St Charles, IL
- NPI 1346649423
-
- Chiropractor
- Norridge, IL
- NPI 1720263700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1639213291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 E MAIN ST",
"address_2": "A",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601742374",
"telephone_number": "630-450-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1434 E MAIN ST",
"address_2": "A",
"city": "SAINT CHARLES",
"state": "IL",
"postal_code": "601742374",
"telephone_number": "630-450-5515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "ANITA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038-010318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.